Six sigma (A3) project
War_re
sharktankpp-kioskrevisedcopy.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: Define
| Date Chartered: | Start Date: | Target Completion Date: |
| 02/03/2014 | 02/05/2014 | 6/09/2014 |
| Improvement Team Members: | Phone/Contact Information | |
| Larry Wilkerson | ||
| Valerie Williams, Education Coordinator | ||
| Joycelyn Westbrooks, Clinical Nurse Educator | ||
| Belt Advisor: (YB requires GB, GB requires BB) | Yellow | |
| Process Owner: | Aslie Burnett and EVAL Team | |
| Sponsor: | Adam Walmus | |
| Opportunity/Problem Statement: (support with data; why is this improvement necessary?) | ||
| Problem Statement Every day MEDVAMC is receiving complaints from Veterans. The Veterans are dissatisfied with extended wait time in long lines at the check-in process within the clinics, resulting in a negative impact on the hospital performance reports. 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. | ||
| Aim Statement: (should flow from the opportunity statement, SMART) | ||
| By June 09, 2014, the Emerging VA leaders will introduce the self-service check-in kiosk, improve user understanding, reduce wait time in long lines, and increase the kiosk check-in process by 20% or more. The Veterans will report increased satisfaction of their check-in experience through the utilization of the innovative technology. Scope: Improving the check-in process for patients through innovative technology (Self-service check-in Kiosk). Start: When the Veteran arrives to the clinic Stops: When the Veteran is called to the back to see a provider. Constraints: Resistance from Veterans using the Kiosk |
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Current State/Initial state
Kiosk Interaction/Transaction for (February)
Kiosk Interaction by Kiosk Date Range: 02/01/2014 to 02/28/2014 Interactions Houston Dental Houston Dermatology Houston Eye 353 472 476 Kiosk Interaction by Kiosk Date Range: 02/01/2014 to 02/28/2014 Transactions Houston Dental Houston Dermatology Houston Eye 362 483 526
Patient Arrive
Welcoming patients and advising how to use the check in Kiosk
Check-in using Kiosk
Wait in the waiting room
Pick up patient
Improve the timeliness of the check-in process
Improve patient satisfaction
Improve check-in experience
Educate the Veterans
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Low Moral Patient Access/Wait Time Dental Elgibility Staff Shortage/Burnout
| SIPOC Diagram | ||||
| Suppliers | Inputs | Processes | Outputs | Consumers |
| Check-In Kiosk and Employees Check-in Kiosk And Employees Check-in kiosk and Employees Check-in Kiosk and Employees | Phone orders Training & Educating Training & Educating Training & Educating | Patient arrives to clinic and walks up to the check-in kiosk Patient touch the kiosk screen to begin check-in process Appointment check-in or view future appointment. I do not have ID or scan card or swipe card. Please enter birthday or confirm or edit. Question: Is this your name? Update demographic Insurance verification Confirm appointment Todays appointment do you want to print Optional to print future appointments | Checking in veterans. Through increase visibility, education, and repetitive instructions, the KIOSK Check-in will be the premier innovation for veterans access to care. Improve check- in experience Improve patient Satisfaction Improve timeliness of check-in | Patients, & Patients families Patients & Patients families Patients & Patients families Patients & Patients families |
SIPOC Analysis and Map Chart
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 & Vet link 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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CTQ’s
New system to reduce
Veteran Check-in Wait time.
To create KIOSK enthusiasm and grow confidence by increasing users understanding of its functionality, purpose and benefit.
Older Veteran
Younger Veteran
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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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 Experiments PDSA’s Feb 6, 2014- June 09, 2014
| Description of the PDSA (What is the plan or action you are testing) | Who, What, Where, When, How (who is leading the PDSA, What data or information are they to collect, how , and when ) | What is the expected outcome of the PDSA? | Actual PDSA Trial Results Data (baseline and results) | What are the next actions? |
| Kiosk Interaction vs. Transactions | Who: Aslie Burnett, Lead MSA, The entire EVAL Team, Valerie Williams, Education Coordinator, Joycelyn Westbrooks, and Larry Wilkerson, What: Kiosk interaction/transaction report How: By collection of the data listed above. | Improve kiosk check-in by 20% within 90 days | PDSA results: Improved by 44% within 90 days Weekly huddles and Monthly classroom meetings | Review data weekly to identify outcomes. |
| Reduce wait time in long line | Who: Same as above What: 100% review and follow-up of the VOC survey How: By collection of the data listed above. | A reduction in the overall check- in time by 15% within 90 days | Improved wait time in long lines by 60% within 90 days Weekly huddles and monthly classroom meetings. | Review data weekly to identify outcomes. |
| Improve users understanding of Self-Service check-in kiosk | Who: Same as above What: 100% review of VOC survey How: By collection of the data listed above. | Improving users understanding by 50% within 90 days | Faster and easier to check in 75% within 90 days Weekly huddles and monthly classroom meetings. | Review data weekly to identify outcomes. |
| Increase satisfaction of check-in experience | Same as above What: 100% review of VOC survey How: By collection of the data listed above | Improving customer satisfaction by 25% within 90 days | Increase patient satisfaction by 90% | Review data and identify outcomes. |
Completion Plan
| What | Who | By When |
| Standard work documented | Kendra Price-Mayes & Larry Wilkerson | 03/4/2019 |
| Communication plan Executed | Aslie Burnett & ‘The EVAL Team’ | 04/6/2019 |
| Education Plan Executed | Aslie Burnett & The ‘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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Confirmed State
| Metric | Current (February 2014) | Target (May 2014) | Actual (March 2014) | Actual (April 2014) | Actual (May 2014) |
| Kiosk Interactions vs. Transactions (Hou Dental) | 5% | 20% | 376/388 | 489/493 | 670/679 |
| Kiosk Transactions vs. Transactions (Hou Eye) | 10% | 20% | 518/526 | 675/684 | 926/947 |
| Kiosk Interactions Vs. Transactions (Hou Dermatology) | 11% | 20% | 525/532 | 684/693 | 938/965 |
Increase kiosk check- in by 37%
Increase kiosk check-in by 44%
Month 1
Month 2
Month 3
Increase kiosk check- in by 25%
Confirmed State
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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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 Interaction 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 Housto n Dermatology Houston Eye 679 965 947
Kiosk Interaction February
Kiosk Interaction by Kiosk Date Range: 02/01/2014 to 02/28/2014 Interactions Houston Dental Houston Dermatology Houston Eye 353 472 476 Kiosk Interaction by Kiosk Date Range: 02/01/2014 to 02/28/2014 Transactions Houston Dental Houston Dermatology Houston Eye 362 483 526
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
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.
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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.
