Vincent Omachonu, Ph.D.

1. IMPROVING SERVICE DELIVERY Process Improvement A Community Event Sponsored By Health Foundation of South Florida Presented By Vincent Omachonu, Ph.D.

2. The Physicians’ Experience The Patients’ Experience The Staffs’ Experience Data and Information Organization-al Culture The Next Level An HFSF Community Event By Vincent Omachonu, Ph.D.

3. UNDERSTANDING PROCESS VARIABLES The Patients’ Experience The Physician’s Experience Staff’s Experience Organizational Culture Use of Data and Information

4. Process Improvement and the Customers’ Experience HFSF Community Event 2007

5. VOICE OF THE CUSTOMER Confidential Excerpts from the Diaries of Customers

6. Process Improvement and the Physicians’ Experience HFSF Community Event 2007

7. VOICE OF THE CUSTOMER Confidential Excerpts from Interviews With Physicians

8. Process Improvement and the Staff’s Experience HFSF Community Event 2007

9. An Interview with an Ex-Employee of a Health Center

10. Summarizing the Staff’s Experience Incompetence Lack of Training Insufficient Training Staff Turnover Lack of Accountability

11. Process Improvement and Organizational Culture HFSF Community Event 2007

12. Managing Process Variations

13. Sources of Variation Human Material Methods Equipment Environment

14. Process Mapping and Value Stream Analysis

15. COORDINATING AND INTEGRATING CARE Primary Care Providers System-Wide Case Management System-Wide Integrated MIS Other Secondary and Tertiary Care Providers Hospital Systems System-Wide Coordinated Referrals

16. Grant Management Process Small Federally Qualified Health Centers Grants Due Dates Grants not Linked to Org. Mission Lack of Expertise Effective Grant Management Process Supplemental Reapplication Reporting Requirements Baseline Data & Indicators Lack of Structure Funding Interaction Sustainability

17. Process Improvement and the Use of Data & Information HFSF Community Event 2007

18. STRUCTURE MEASURES Available Capacity to Provide Services Average Provider Support Staff Ratio: # Provider FTEs # Support Staff FTEs Physician Lateness Absenteeism Vacation Schedules Practice Styles Other Duties Reassignments Trips to Medical Records Trips to Pharmacy Absenteeism Tardiness

19. STRUCTURE MEASURES Availability of Patient Information Percent Missing Information # Missing Information # Charts Reviewed Lab Results Patient Demographics Organization of Records Lack of Uniformity Progress Notes Billing Issues Adequate Sample Size Chart Review Follow-Up Regulatory Agencies policies & Procedures

20. PROCESS MEASURES Access to Care Availability of Appointments # Days to Receive Appmt # Pts Requesting Appmts Physician Availability Nature of Visit Clinic Hours of Operation Management of “No Shows” Scheduling System Specialists’ Coverage Availability of Results Appointment Reminders Type of Appointment Staff Attitude Caring Culture Walk-ins Pt’s Time Constraints Transportation

21. PROCESS MEASURES Cycle Time Per Patient – Measure of Patient Flow Time In to Time Out Total Cycle Time # Pts Processed Managing Walk-Ins Physician Practice Style Availability of Patient Info Completeness of records Scheduling System Competency of Support Staff Appointment Reminders Scheduling System Staff Attitude Caring Culture

22. OUTCOME MEASURES Improvement of Health Status Health Outcomes Status # Patients with Improved H. Status # Patients Receiving Care Diabetes Hypertension HIV/AIDS Patient Education Preventative Care Coordinated Care Treatment

23. CONCLUSIONS

24. QUESTIONS ?