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Washington’s Lean Journey . Anneke Jansen, MPH – Amendment Supervisor. July 2011 – June 2015 CHS Strategic Plan.
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Washington’s Lean Journey Anneke Jansen, MPH – Amendment Supervisor
July 2011 – June 2015 CHS Strategic Plan Goal: Transform the Center for Health Statistics into an organization that is continuously improving the quality and efficiency of our data and services to meet our customers’ needs today and into the future. Objective 2: Integrate quality improvement processes into the routine business of the Center.
Our Journey Phase 1 (12/2011 – 4/2012) • Small projects to show quick results • Highlight “just do it’s” • Gain trust from staff Phase 3 (7/2013–1/2014) • Integrating daily lean • Move from defense to offense • Performance measures December 2014 December 2011 Phase 1 Phase 3 Phase 4 Phase 2 • Phase 2 (5/2012–6/2013) • Big projects using VSM • Expanding reach across the Center • I wonder why… • Phase 4 (2/2014 – Present) • Policy & law changes using lean management • Standardization of large processes • Continue expanding and improving daily routines
Death Registration to Data Release • Registration and issuance • Cause of death entry and coding • File close activities (year-round) • File dissemination
Clear auditor’s report Unhealthy Back to county Upload 1xwk Prep paper records for imaging Data Enter Healthy Number Paper Receive Sort Send to SSA Pick up paper docs Image records Upload images Paper docs returned Records entered into Super Micar Certs available in CertIMS to issue Receive Demo error report Clear edits Update COD Query letters sent Files sent to NCHS and other states through STEVE Extract data file Upload 2xday Cleaning Data EDRS EPI reviews COD .trp/ .trx files COD: returned for correction and upload to Close NCHS file (WA State Occurrences) Close CHS file (WA State Residence) Data files available for order Receive data order and check Upload data set to secure file transfer Email customer order filled
Paper Death Registration & Electronic Issuance Project Aim: Decrease number of days to register a paper death record from 100 calendar days to 16 calendar days by November 1, 2013. Current State (as of 2/2013) Identified Future State Touch Time: 16 minutes Queue Time: 14.5 days Lead Time: 16 days • Touch Time: 3-4 hours • Queue Time : 60-90 days • Lead Time: 65-107 days
Performance Measure: Days b/w Received and Image Available Reduced marriage and divorce batch size Daily stand-ups started Marriage certificates prioritized 2 data compiler positions empty
Clear auditor’s report Unhealthy Back to county Upload 1xwk Prep paper records for imaging Data Enter Healthy Number Paper Receive Sort Send to SSA Pick up paper docs Image records Upload images Paper docs returned Records entered into Super Micar Certs available in CertIMS to issue Receive Demo error report Clear edits Update COD Query letters sent Files sent to NCHS and other states through STEVE Upload 2xday Reviews Files Extract data file EDRS EPI reviews COD .trp/ .trx files COD: returned for correction and upload to Close NCHS file (WA State Occurrences) Close CHS file (WA State Residence) Data files available for order Receive data order and check Upload data set to secure file transfer Email customer order filled
Data Sharing Then Current State 2 order forms 1 tracking sheet used by all Standard and documented processes 89% of all data orders filled within 2 business days 100% of death file orders filled within 2 business days • 17 order forms (13 for death) • 6 tracking sheets used by few • Variable and individual processes • Time to fill orders couldn’t reliably be tracked
Clear auditor’s report Unhealthy Back to county Upload 1xwk Prep paper records for imaging Data Enter Healthy Number Paper Receive Sort Send to SSA Pick up paper docs Image records Upload images Paper docs returned Records entered into Super Micar Certs available in CertIMS to issue Receive Demo error report Clear edits Update COD Query letters sent Files sent to NCHS and other states through STEVE Upload 2xday Reviews Files Extract data file EDRS EPI reviews COD .trp/ .trx files COD: returned for correction and upload to Close NCHS file (WA State Occurrences) Close CHS file (WA State Residence) Data files available for order Receive data order and check Upload data set to secure file transfer Email customer order filled
Things to Remember • Engage staff • Start small and build • Ensure changes are improvements • Incorporate performance measures into business • Stick with it and follow through • Dream big (set your vision) while planning for short term • Be flexible yet persistent • Management support and engagement
In the Words of CHS Staff It’s like my head exploded! You just have to change the way you look at things. I take more pride in my work because my input is heard. Event if it’s not implemented. It validates your job is important. Management drives culture. I am surprised at how empowering it is for staff. A way to change what’s not working for them. Don’t give up when it doesn’t work out at first. It’s scary at first, we’re so used to doing things we felt were working all right. Make sure everyone is on the same page with why you’re doing change and understands the change. I knew it would work. I just never thought it would work this well.