Kaizen Applied to Public Health Improvement - Christopher J. Bujak and Pam Vecellio

Overview of the Kaizen Initiative

A Kaizen Leader Training Program was instituted as part of the Community of Practice for Public Health Improvement (COPPHI). The project was managed by The National Network of Public Health Institutes (NNPHI), implemented in partnership with Continual Impact LLC, and funded by the Robert Wood Johnson Foundation.

The program selected ten health departments to receive training, coaching, and materials that enabled a Kaizen-trained leader in each facility to form a Kaizen team and co-lead a quality improvement (QI) project using the Kaizen event technique. The Kaizen method instruction followed the guidance provided in the Kaizen Desk Reference Standard.

The Kaizen approach’s hallmarks are its focus on "identifying and eliminating waste in a work process, increasing the value of the outputs of the process, active engagement of staff at multiple levels of the organization, and [producing] speedy and sustainable results … . This method has proven effective in a number of health departments across the country, and we look forward to seeing results of Kaizen process improvements achieved by the grantees," said Pamela Russo, Senior Program Officer, Robert Wood Johnson Foundation.

Before each event, a kaizen-appropriate problem was identified and goals set. The areas addressed included customer satisfaction, cycle time and labor reduction, and error elimination. Every event used a systematic process to identify waste in the targeted work process; analyzed its root causes; identified, tested, and installed improvements; created a follow-through system for maintain improvements, and extracted learning that will be leveraged by transfer to other sites and problems. The teams accomplished their projects in a relatively brief period of time with full benefits achieved within 1-3 months!

Armed with the training, preparation, and an on-site QI Coach from Continual Impact LLC, the ten health departments each conducted a Kaizen event over a five-day period. The trained staff teams at each health department used their new skills to tackle issues such as increasing efficiency in purchasing processes, increasing completed child developmental screenings, and improving shared drive usage. The lessons learned from these leaders are being used to inform future directions for continuous improvements using the Kaizen method.

Summary of Results

Each team measured and reported out its results. A composite table was produced to summarize the goals, baseline performance before the event, target for improvement, results realized (through May 2014), status of results relative to improvement goal, and, where possible, a return on investment calculation estimating the first year's return on every dollar invested in the corresponding event (ROI ).

Download Table Summarizing the Results of All Ten Events

Individual Project Summaries

The links below provide a narrative summary of each project. Use them to better appreciate the purpose, approach, and outcome of each event.

1. Hangin' on a Call Lookin' for a Live Body- El Dorado County Health and Human Services Agency

El Dorado County Health and Human Services Agency used a Kaizen event to improve customer satisfaction and reduce labor time in the County “request for information” process. The results of the project mean better and faster information to the incoming …read

2. Environmental Health Child Care Facility Inspection Process: What to Expect When You're Inspected - Washington County Public Health Division

Washington County (OR) conducted a Kaizen Event to improve the volume of childcare facilities that used the LHD for their state required inspections. The agency implemented several new policies and protocols to standardize the entire … read

3. Client Feedback Process - Clackamas County Public Health Division

Clackamas County, Oregon conducted a comprehensive Kaizen project to design and implement a customer feedback system for the entire public health division. The process and tools used for the project are well described and … read

4. Increasing ASQ-3 Child Developmental Screenings: Quantity and Validity - Fond du Lac County Health Department

Early intervention has been shown to positively impact outcomes across developmental domains. The Fond du Lac County Health Department increased the number of children being screened for developmental delays from 5 to 9 per … read

5. Death Certificate Filing - DeKalb County Board of Health

DeKalb County Board of Health used a kaizen event to decrease the labor time and increase the accuracy of filing death certificate registrations. Improving the process resulted in labor savings to the department, better cash flow and improved … read

6. Tazewell County Health Department Food Inspection Process - Tazewell County Health Department

Kaizen events lend themselves to rapid improvements in routine health department processes. Tazewell County Health Department utilized Kaizen tools to full advantage--reducing administrative time related to food establishment inspections dramatically … read

7. Processing Low-Priority Chlamydia and Gonorrhea Reports - Chicago Department of Public Health

Untreated chlamydia (CT) and gonorrhea (GC) can lead to serious health problems in men and women. In order to effectively track and treat these two sexually transmitted infections … had been experiencing a large backlog of these reports, and used a kaizen event and PDCA approach to dramatically reduce the processing and backlog time in order to improve the surveillance and control of these infections … read

8. Increasing Purchasing Process Efficiencies - Florida Department of Health in Seminole County

DOH-Seminole County realized savings of $7764 for goods and services from price negotiations during the first quarter following a Kaizen event – almost double the goal set by the QI team. Other improvements in the requisition process included a 38% decrease in process time … read

9. Johnson County Department of Health and Environment-Supply Ordering Process - Johnson County Department of Health and Environment

Johnson County Department of Health and Environment used a kaizen event to improve the supply ordering process cycle time and increased the order placement and delivery accuracy for all programs in the department. The results included decrease in cycle time – total ordering process time per order from 93 to 16.5 minutes, (82%) time and improving the order … read

10. T-Drive Alive-Organizing a Shared Network - Three Rivers District Health Department

By streamlining their internal computer drive, creating an internal framework for its use/upkeep, and training staff on the efficient and effective use of the computer drive, the Three Rivers District Health Department has increased … read

Further Information

For further information about the approach and the training implemented, contact Christopher J. Bujak at Continual Impact LLC. Also, access and use the following informational sources:

1. Kaizen: Would you like to have more speed, involvement, and results for your improvement projects?
2. Kaizen Article 2 of 4: Who are your customers?
3. Kaizen Article 3 of 4: People
4. Kaizen Article 4 of 4: Labor Time and Waste Reduction
   

Published October 21, 2014, Revised October 30, 2014

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