Implementing Quality Improvement Tools to Address Four Challenges in Houston


Impact Statement: 
The Health Department improved the process for obtaining birth and death certificates so customers weren’t forced to miss time from work or take other extraordinary steps to obtain these vital documents in a timely fashion.

The Houston Department of Health and Human Services (HDHHS) trained 25 employees in quality improvement (QI) tools and techniques and built its internal capacity to teach QI by hosting the QI Star TRaK (Training, Resources, and Knowledge) Train-the-Trainer (TTT) series. Participants were arranged into four groups and identified four QI projects to pursue: (1) decreasing HIV pending case load, (2) new employee orientation, (3) cost of lab services, and (4) decreasing vital statistics customer wait time. All projects are actively using QI methods to address areas of improvements; however, reducing customer wait time provided an opportunity to immediately meet the needs of the customer and improve an HDHHS service effectively and efficiently. An opportunity existed to improve the vital statistics area customer flow, and reduce customer wait times through QI methods learned during the HDHHS QI Star TRaK series. Customers were waiting nearly one-half hour to process vital statistics transactions. Long waits to receive service have widespread effects, including forcing customers to miss time from work to obtain a birth or death certificate. Using the Plan-Do-Check-Act (P-D-C-A) cycle and other QI methods, the QI team implemented a pilot test to increase the number of cashier windows open to accommodate the customer demand. The pilot reduced customer wait-times by 50% from approximately 30 minutes to 15 minutes. To help maintain this reduction in customer wait-time, the program revised the standard operating procedures for cashiers, hired temporary staff to support other program responsibilities, and revised the program sick/vacation time policy to maintain appropriate staffing levels in all areas. The vital statistics program has assumed responsibility for the P-D-C-A cycle and continues to identify areas and opportunities to improve program effectiveness in servicing the residents of the City of Houston.

Organization that conducted the QI initiative: 
Houston Department of Health and Human Services

Arafat, D. Public Health Quality Improvement Exchange. Implementing Quality Improvement Tools to Address Four Challenges in Houston. Thu, 12/27/2012 - 16:08. Available at Accessed April 14, 2024.

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