The Orange County Health Department in Florida chartered a QI team to reduce total time for administering child immunizations. With assistance from Grace Duffy, the QI team identified a number of disruptions to the process, including times when patients’ families were waiting to be interviewed and for children to receive their immunizations. Once the inefficiencies in the process were identified, the QI team and the immunization nurse manager redesigned the clinic flow. As a result, all waiting was removed. Patient time was reduced from 33 to 4 minutes, while overall process time was reduced from 16 to 11 minutes.
 

Additional efficiency gained through correcting inaccurate and missing client data resolved significant disruption to the immunization team as well as to the billing department. Reliability of information within the client record allowed asynchronous access to the information by billing and expedited checkout so it could be collapsed into the previous process step. Reducing the patient time required to go through the immunization process increased the reputation of the clinic. Word of mouth among the client base encouraged more of the population to use child immunization services.

 

Click here to view a Value Stream Map measuring how long each major step in the immunization process took before the process was improved.