The Quality Improvement Committee at the Sedgwick County Health Department (SCHD) in Kansas identified improving the wait time for the Women Infants and Children (WIC) clinic as one of the eight improvement areas to address in an effort to
develop a culture of QI at the agency.
AIM Statement
To provide standardized reminder calls to all WIC clients one day before their scheduled appointment to increase client preparedness for appointment.
Plan
Team members were tasked with reviewing WIC clinic wait times and identifying areas for improvement. Project team members were from several different programs within the health department: WIC (2), Healthy Babies (1), and Health Protection and Promotion (1). The overall flow of the WIC clinic was reviewed and discussed. The project team brainstormed possible causes for increased clinic wait times.
One area that WIC clients have communicated as an area of frustration is the additional wait times that occur if their paperwork is not complete prior to their scheduled appointments. This was also identified as a cause of increased wait times by WIC clinic staff.
Identify Potential Solutions
a. Develop a script for WIC clerical staff to use when making reminder calls to clients.
b. Provide training to WIC clerical staff on the reminder calls.
Develop an Improvement Theory
If clients receive a standardized reminder call informing them of the time of their appointment and necessary documentation to have completed, then the clients will arrive on time better prepared for appointment. This will result in decreased wait times.
Do
WIC staff developed a script for a standardized reminder call to be used for clients. A staff training was conducted with clerical staff, and the standardized reminder calls were implemented.
Client paperwork was tracked pre- and post-reminder call implementation to look for any changes.
Study
Client paperwork was tracked for a 3-day period during a time when clients were not receiving standardized reminder calls. WIC clerical staff were later trained to use a script that was developed for the standardized reminder calls and began using this script when calling clients. Client paperwork was again tracked for a 3-day period during the time that clients were receiving the standardized reminder call.
Act
a. Data suggests that providing standardized reminder calls to all WIC clients prior to their scheduled appointments may not be a productive use of time.
b. Paperwork compliance may require more extensive efforts on WIC staff, involving relationship building with client.
c. Evaluating compliance based on the type of client (eg. new client vs. recertification) may provide more insight to paperwork compliance barriers.
Establish Future Plans
Possible plans for future projects could include:
a. Reviewing the overall flow of the WIC clinic to determine other areas of improvement for decreasing wait times.
b. Reviewing processes and wait times at other WIC sites.