RIE VACCINE INVENTORY MANAGEMENT

1. RIE VACCINE INVENTORY MANAGEMENT FEBRUARY 25 – 27, 2013 Executive sponsor – Dr. Judy Shlay Process Owner – Sarah Rodgers Lean Lead – Kathy Root Participants – Lori Ramirez, Dean McEwen, Alexis Juarez, Ashley Oliver, Marianne Aguirre-Colon, Andrew Yale, Heather Weir, Melissa Edel, Kathie Chichester, Kristi Yamaski

2. REASON FOR ACTION • Inefficient use of resources – financial and staff • Improving/creating standard work • Adhere to federal and state laws • Adjusting inventory

3. GOALS AND OBJECTIVES • Standard practice • Easy process • Immunizations and apply to other programs/agencies • Root cause • Minimize errors and safety • Decrease financial errors • Reduce staff burden • Patient satisfaction and wait times

7. WASTE WALKDefects • Clerk writing too much important info on routing slips • Lot # list not being used • Lot # list • Vaxtrax pulling incorrect lot # • Using the wrong lot # • Multi user friendly files • Order too often • Par levels • Too few people knowing the process • Missing QA of correct lot # being used • Routing slip does not have standard documentation • Self pay defaults to VFC eligible in Vaxtrax

8. WASTE WALKUnused Human Talent • Nurse is faxing and copying • Handwriting • Wrong person is ordering • Nurse asking for payment and printing records • Nurse/clerk charting

9. WASTE WALKWaiting Time • Data entry into Vaxtrax • Confirmation fax • Streamline process • Determine lot # before bringing patient into clinic room

10. WASTE WALKInventory • Multi inventory books • Visual assessment of vaccine needed • Rebalancing of inventory • Delay in billing/chart review

11. WASTE WALKTransportation • The back and forth of patients • Standard process of vaccine boats • Movement of forms

12. WASTE WALKProcessing • Fixing lot #’s • VFC vaccine processing report • Sending email twice to billing person if denied claim • Too many forms • Using lot # form routing slip

13. WASTE WALK Overproduction • Paperwork for patient • Paperwork for inventory • Un-useful Vaxtrax reports • Billing reports • QA every visit

14. PRIORITIZATIONImpact Effort Plot used to prioritize Rapid Experiments Impact to customer Level of effort each action requires Low High Low High

15. RAPID EXPERIMENTS • Forms & Stickers: • Created new labels for the routing sheet to cover the lot #’s • Developed new consent forms • Wrote standard billing procedures • Fridge & Opening/Closing Procedures: • Reorganized immunization refrigerator • Developed Start/End of Shift Checklist • Improved Inventory Lot Number list – Alphabetized, color-coded by VFC/317/Private • Ordering process • Par levels • Standardized ordering process • Improved ordering form for private vaccines • Updated ordering procedures and process • Updated binders

16. CONFIRMED STATEMetrics/Visual Management Board • Financial Increase donations baseline is January’s donation amount goal – 10% increase by April • Ordering Retro report of # of times ordering Private order per month Time study of old vs. new ordering system Baseline done now Goal - undetermined • Quality assurance – lot/site/program/wrong pot Baseline – 30% Goal – less than 5% 4) Employee satisfaction – survey changes after 45 and 90 days

17. COMPLETION PLAN

18. INSIGHTS • Organized • Everyone participated • More in-depth and intense than expected • Opportunity for improvement • Relieved • Good team • Right people in the room