A3 six sigma (lean management )
War_re
SharkTankPP-Kiosk.pptx
Check-In Kiosk
Eval Class of 2014
Aslie (Ashlie) Burnett-Project Facilitator
Overview
Michael E. DeBakey Veterans Affairs Hospital has been a leader in quality care since the 1930s, by serving, honoring, providing care to the men and women who are America’s Veterans. We have upgraded the facility and enriched technology to better meet the needs of our veterans- we are now excited to introduce a first-ever check-in kiosk .
Reason for Action
Problem Statement
In 2014 MEVAMC had reduced usage of innovative technology and complaints of long lines and long wait times lead to external customer dissatisfaction.
Business Case
The delay affects the customer's gratification, institutional status in the waiting area of the hospital corrective actions from higher authorities in reply to client criticisms and puts extra pressure on internal clients.
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Reason for Action
Aim/Goal: Within 90 days, MEDVAMC Emerging VA Leaders will introduce the self-check-in kiosk, increase users' understanding of its functional purpose and benefits, improve patient satisfaction by reducing wait time and improve the kiosk check-in by 20%.
Scope: The check-in process for patients
Start: When the patient arrive to the clinic
Stops: When the patient is called to the back to see a provider.
Constraints: limited knowledge of kiosk
Start with areas that have high number of repeat patients
Start with check in and payments, then add functions as desired
Use a greeter during initial rollout
Place the kiosks in an obvious location
Enable as many languages as you reasonably expect to use
System selectin
Freestanding kiosk and countertop kiosk
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6 Ambassadors
3 Actors
4 Graphic designers
3 people from volunteer services
Sponsor (Adam Walmus, MEDVAMC Director (2014)
Valerie Williams, Education/ EVAL coordinator
Joycelyn Westbrook
Larry Wilkerson
Kendra Price-Mayes
Team member/ Project Facilitator: Aslie Burnett
Natalie Delahoussaye
Merisha Freeney
Gregory Austin
Karl Murray
Shauna Babers
Grant Lenued
Chakita James
Tonya Hackney
Katress King
Sharice Easterling
Diana Pham
Shirley Collins
Rickey Reed
Members from Volunteer services
Surveys: were done with 98 patients from the 100 surveyed cases to estimate self-check-in awareness level, check-in experience, successful check-ins, timeliness of check in process, and why they used the kiosk.
Kiosk Interactions Report: Displayed how many interactions vs. transactions
A team was formed to survey customers in three piolet areas: Dental, Dermatology, & Eye clinics.
The Current State
Based on the current state, out of 79 patient complaints the top dental complaints were dental eligibility and patient access/ wait time.
Based on the all employee survey the top complaints were low moral amongst dental personnel and staff shortage/ burnout
Voice of customer: SHEP survey’s, v-signal, and share your experience
Voice of customer: All employee survey’s
Low Moral -15%
Patient Access/Wait time-46%
Dental eligibility-29%
Staff shortage/burnout- 10%
Process mapping to figure out the wastage
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Low Moral Patient Access/Wait Time Dental Elgibility Staff Shortage/Burnout
Appendix 1: Focus Group Protocol
Section 1:
MEDVAMC KIOSK SURVEY
Michael E. DeBakey VAMC is working on a research project to understand how patients experience using the new kiosk in the waiting area. The results of this survey will help us provide better care to patients.
Please take a moment to fill out this short questionnaire so we can better serve you as a patient in the future. Your answers are anonymous, which means that they cannot be traced back to you in any way. Your doctors and nurses will not see your answers. Taking part in this study is voluntary. This means that you can choose whether or not to fill out the survey. When you finish the survey, please put it in the drop box by the front desk or hand it to a greeter.
If you have questions about the kiosk, please contact Aslie Burnett at ext. 28576.
1. How comfortable did you feel using the kiosk? (check one)
Very comfortable
Comfortable
Somewhat comfortable
Not very comfortable
Not at all comfortable
2. Were you aware of the new self-service check in option (check one)?
Yes or No
3. How comfortable were you with the privacy level offered by the kiosk?
Very comfortable
Comfortable
Somewhat comfortable
Not very comfortable
Not at all comfortable
4. Why did you use the kiosk for today’s visit?
5. What did you like about using the kiosk?
6. Were you able to successfully check in to the kiosk?
Yes or No
7. Is there anything else you would like us to know about your experience with the kiosk?
8. Did the greeter in the waiting room improve your experience with using the kiosk?
Yes or No If YES, please explain how
When you finish the survey, please put it in the drop box by the front desk. Thank you!
Used the kiosk interaction report
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8 forms of waste
Defects-space constraints
Overproduction
Waiting –patients waiting (idle time)
Not utilizing human potential-staff not trained on Kiosk system or software
Transportation
Inventory
Motion
Excessive processing
Strength
Labor reductions
Weakness
Opportunity
Kiosk already available
Threat
Increased patient complaints
Wait time reduction
Convenience
Customization
Visual impaired
Improve accuracy of demographic data
Improve customer service
Software Development
Maintenance
Space constraints
Employees not trained on Vet Link software
Employee refusal to utilize the Kiosk & Vetlink system
Incorporate surveys
Alleviate language barriers
Employee burnout
Patients opt-into civilian care
Veteran refusal to utilize kiosk system
Hire more staff
Offer copayment capabilities
Best Practices for Implementing Kiosk
System Selection
Select a kiosk with the physical location in mind.
Considering more than one kiosk per area/department.
Take advantages of branding opportunities.
Deployment
Start in areas with high numbers of frequency.
Start with check-in/ insurance verification.
Use a greeter during the initial rollout.
Choose an obvious and convenient location.
Enable as many languages as reasonable.
Policies and Procedures
Make use of the patient kiosk optional.
Assign basic oversight responsibilities.
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The target state
The key target state in following this approach is to address the time wastage.
Hence, ultimately, the patient checking in time and their leaving time shall be accounted for upon completion of this project.
Communication with the public and patients regarding the dental healthcare wait/access time will promote awareness on the issues leading to delays in the healthcare system.
The offering of incentives and rewards to performing employees will promote their attitude towards work. Hence, physicians will offer quality service to patients leading to a satisfied customer base.
Careful scheduling and planning in all departments is essential e.g. good arrangement of dental equipment will lead to reduced wait/access times.
Effective community-based dental services will offer quality service to patients leading to lower wait times in the dental healthcare, and efficient management of dental emergency platforms.
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Gap Analysis
| Problem Statement: | |
| Gap | How to Address |
The implementation step involves ensuring that all the recommended strategies are effective in the dental care unit in the healthcare facility involved
Holding us back-Dental Eligibility, Leadership not motivating staff, shortage of staff
Root cause analysis – not being properly educated, leadership implementing change without staff perspective or views , HR delays
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Execution Timeline
Month 1
Month 2
Increase kiosk check-in by 5-10%
Increase kiosk check- in by 15%
Month 3
Increase kiosk check-in by 20%
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Target Audience
Older
Veterans
Younger Veterans
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3 Ways of Marketing KIOSK
Instructional Video
Pamphlets
Signage
YouTube: Informational video record by Reginald Sasser in medical media
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Marketing Plan:
VA Publications
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Pop-up sign
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Guerilla Marketing
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Quarter review of marketing plan
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Educational Television
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Sign affixed to KIOSK
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Michael E. DeBakey VA Kiosk Pamphlet
CHECK-IN TODAYS APPT.
SCREEN 1
CHECK IN TO APPOINTMENT OR
VIEW FUTURE APPT.
SCREEN 2
I DON’T HAVE ID OR SCAN CARD OR SWIPE
SCREEN 3
PLEASE ENTER BIRTH DATE
.CONFIRM OR EDIT
SCREEN 4
IS THIS YOUR NAME
SCREEN 5
CONTACT INFORMATION
EDIT OR PROCEED
SCREEN 6- PROCEED
INSURANCE INFORMATION
SCREEN 7- PROCEED
NEXT OF KIN
SCREEN 8
TODAY’S APPT DO YOU WANT PRINT
CONFIRMATION FOR CHECK-IN APPT
SCREEN 9
DO YOU WISH TO PRINT FUTURE APPT
If you have any questions or concerns, please contact the coordinator (Larry Wilkerson) @:
713-791-1414 ext.
!!!!! ATTENTION VETERANS !!!!!!
SELF CHECK- IN NOW AVAILABLE
FOR APPOINTMENTS
NO NEED TO WAIT IN LINE, READ THE BACK FOR STEP BY STEP INSTRUCTIONS
EVAL 2014
“Where We Care with our Hearts First”
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Michael E. DeBakey VA Kiosk Signage
Check- In
Here
Cont. Gap analysis
Still applying the 5 whys
Low moral-root cause analysis was lack of communication
Dental eligibility –root cause analysis is poor communication
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Solutions approach
Incentives offered to competent employees may include award recognition and compensatory time.
Adopting a kiosk check in system will aid reduce wait time in long lines
Open access clinics will help the patients acquire specialized dental care
Patients can benefit from receiving appointment slots made on that same day.
Extended hours to patients will help ease the work load and wait time for the subsequent days.
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Rapid experiment to evaluate the effectiveness of the solutions
The first essence of this experiment was to determine the viability of the team and whether they are ready to pursue their sub-projects. Worked with all staff from dental assistants, clerks, leadership, providers
Secondly, I reviewed the role of the projects in dealing with time wastage in the organization.
Thirdly, Team work is dream work- team collaboration with eligibility- Pamphlet created for educating purposes
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Completion Plan
| What | Who | By When |
| Standard work documented | Kendra Price-Mayes & Larry Wilkerson | 03/4/2019 |
| Communication plan Executed | Aslie Burnett | 04/6/2019 |
| Education Plan Executed | EVAL Team | 05/15/2019 |
| Audit plan Executed | Larry Wilkerson | 06/01/2019 |
The completion plan was not on track.
In order to for this to executed by the stated dates to enable sustainment with 90 days
Leading measures:
Communicate new processes
Educated or provide training of new processes
Audit: internal/external reviews
Project Plan
Define phase 5/01/2014 to 5/31/2014
Measure phase 04/01/2014 to 04/31/2014
Analyze step 03/01/2014 to 03/31/2014
Improve stage 04/01/2014 to 05/01/2014
Control phase 06/01/2014
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Completion plan
Appropriate analysis and alignment of my project- I ensured that my project connected with the established mission, vision, and value
Appropriate planning for quality from the commencement of the project- I met with the stakeholders to discuss quality issues for every deliverable since the beginning on the project development
Beginning with the end user in mind- for every deliverable, I ensured that I reflected on what the clients wanted.
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Ensuring that the project implementation is successful depends on the steps that the project manager takes in the former stages. Some key strategies that I used to ensure sustainability in this case included the following:
Appropriate analysis and alignment of my project
Appropriate planning for quality from the commencement of the project
Beginning with the end user in mind
Completion Plan
Weekly huddles: improve situational awareness
monthly meetings
In order to for this to executed by the stated dates to enable sustainment with 90 days
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All individuals affected by the change in procedural operations of Kiosk check-in system making sure they are on board
Training of the personnel upon changes to procedure.
Offer sustainable employee engagement during the change.
Utilizing internal/external feedback
Kiosk Interactions vs Transactions
Kiosk Check-In's Transactions
Dental Clinic
Dermatology Clinic
Eye Clinic
Kiosk interaction by kiosk
Date Range:5/01/2014 to 5/31/2014 Kiosk
Interactions Transactions
Houston Dental 670 679
Houston Dermatology 938 965
Houston Eye 926 947
Date Range: 04/01/2014 to 04/31/2014 Kiosk
Interactions Transactions
Houston Dental 489 493
Houston Dermatology 684 693
Houston Eye 675 684
Date Range: 03/01/2014 to 03/31/2014 Kiosk
Interactions Transactions
Houston Dental 376 388
Houston Dermatology 525 532
Houston Eye 518 526
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Kiosk Interaction April
Kiosk Interaction by Kiosk Date Range: 04/01/2014 to 04/31/2014 Interations Houston Dental Houston Dermatology Houston Eye 489 684 675 Kiosk Interaction by Kiosk Date Range: 04/01/2014 to 04/31/2014 Transactions Houston Dental Houston Dermatology Houston Eye 493 693 684
Kiosk Interation March
Kiosk Interaction by Kiosk Date Range: 03/01/2014 to 03/31/2014 Interactions Houston Dental Houston Dermatology Houston Eye 376 525 518 Kiosk Interaction by Kiosk Date Range: 03/01/2014 to 03/31/2014 Transactions Houston Dental Houston Dermatology Houston Eye 388 532 526
Kiosk Interaction May
Kiosk Interaction by Kiosk Date Range:5/01/2014 to 5/31/2014 Interations Houston Dental Houston Dermatology Houston Eye 670 938 926 Kiosk Interaction by Kiosk Date Range:5/01/2014 to 5/31/2014 Transactions Houston Dental Houston Dermatology Houston Eye 679 965 947
Confirmed State
| Metric | Current (February 2014) | Target (May 2014) | Actual (March 2014) | Actual (April 2014) | Actual (May 2014) |
| Kiosk Interactions vs Transactions (Houston Dental) | 5% | 20% | 376/388 | 489/493 | 670/679 |
| Kiosk Transactions vs Transactions (Eye) | 10% | 20% | 518/526 | 675/684 | 926/947 |
| Kiosk Interactions Vs. Transactions (Dermatology) | 11% | 20% | 525/532 | 684/693 | 938/965 |
Despite the effectiveness in addressing time wastage in this facility, the management should examine this proposal and implement its recommendations as a means of improving its dental care provision.
However, this project became effective in addressing the time wastage and enabled the clients to have efficient and satisfactory services.
Implementation is a learning and continuous process.
Management should have an eye out for new and better implementation opportunities.
Be more vigilant in offering community-based services if Veteran meets eligibility criteria
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Confirmed State
Month 1
Month 2
Increase kiosk check-in by 23%
Increase kiosk check- in by 37%
Month 3
Increase kiosk check-in by 44%
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Confirmed State
This lean management proposal was effective based on the following reasons.
Patient who checked in with receptionist were interviewed to learn about their awareness level of the new self-service check in option
Patients who checked in with a kiosk were asked about their experience using this tool.
The vast majority of member who checked in using the kiosk has a successful experience with over 75 percent of members feeling that checking in through kiosk is faster than check in through a receptionist
About 60 percent of members report that the reason they used the kiosk was because the line was shorter
More than 90 percent of members who used a kiosk to check in are able to do so successfully without needing any assistance and the same number also report that they felt comfortable with level of privacy it offered by the kiosk.
Kiosk interactions report: Displayed Kiosk interactions vs Transactions
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Insights-box analysis
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There are several reasons projects need to be started effectively and the entire steps focused on to promote sustainability.
For this case, I experienced an issue with wastage and this project endeavored to address it effectively.
I ensured that the piolet areas successfully used my project to improve customer satisfactions, increase utilization of innovation technology, and reduce wait time by checking into the kiosk. In the future I love to implement wayfinding technology on the kiosk check in system.
I noted the that the project implementation is successful depends on the steps that the project manager takes in the former stages and my team worked on all stages effectively.
Conclusion
The plan was to create confidence and eagerness by showcasing our new method of checking in veterans. Through increase visibility, education, and repetitive instruction, the KIOSK Check-in will be the premier innovation for veterans' access.
THANK YOU FOR YOUR SERVICE
Checking in for an appointment is easier and quicker: USE THE CHECK-IN KIOSK
**Located in all Primary and Specialty Clinics**
FOR A SPEEDY CHECK-IN (SCHEDULED APPOINTMENTS)
UPDATE YOUR DEMOGRAPHICS, CONTACT AND INSURANCE INFORMATION
PRINT OUT FUTURE APPOINTMENTS
