Improving Whatcom County Health Department's WIC Scheduling Efficiencies Using Quality Improvement Techniques


Impact Statement: 
A local health department in Washington was not able to serve all of the WIC-eligible clients in its jurisdiction. Process mapping led to three aims for increasing efficiency to make time for new clients: (1) Decreasing the average percentage of no-show appointments; (2) Increasing the WIC appointment completion rate; and (3) Decreasing unfilled available appointment time. Several interventions were tested. During the QI period, client satisfaction increased.

As of July 2013, 1,966 Women, Infants, and Children Program (WIC)–eligible individuals on Medicaid were not participating in a WIC program in Whatcom County. The project aimed to increase capacity to serve additional clients. The mission was to increase the number of eligible WIC clients served, by maximizing use of available appointment time, by August 1, 2013. To achieve this goal, the team needed to address program inefficiencies so the caseload could be increased from a stable 2,200. Process improvements were identified to address scheduling inefficiencies and to address the high number of missed and rescheduled appointments that resulted in unfilled appointment slots in the WIC schedule and created additional staff work. Once the team began, it realized that the original goal of increasing the number of WIC clients served AND improving the efficiency and quality of services for clients were not easily accomplished simultaneously. The team decided to focus first on process improvements to increase scheduling efficiencies and improve customer service. This would create additional appointment availability, a first step in serving additional clients. The team still retained the long-term objective of serving additional WIC-eligible clients. The project targets were as follows: • Decrease the average percentage of no-show appointments from 16.97% to 15%. • Increase the WIC appointment completion rate from 67.91% to 70.0%. • Decrease unfilled available appointment time by 5%.

Organization that conducted the QI initiative: 
Whatcom County Health Department (WCHD)

Molaski, K. Public Health Quality Improvement Exchange. Improving Whatcom County Health Department's WIC Scheduling Efficiencies Using Quality Improvement Techniques. Wed, 02/11/2015 - 15:40. Available at Accessed July 24, 2024.

Submission Status: 
1 user has voted.


Submitted by Amanda Kelly on

Some of our local health department staff just completed Lean Boot Camp and we have more staff attending training in March!  The term "process mapping" stood out on your description!  I was excited to review your project and to actually see how it was used in the "real world" - makes total sense!  Thank you for sharing and best of luck with your project! 

1 user has voted.

Megan Davis's picture
Submitted by Megan Davis on

Thank you for explaining what you learned about the "no-show" data being less accurate than you'd thought. Excellent insight. Also, I am very interested in how the Education Room use has fared since the beginning of the project.  

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Megan Davis
Accreditation Coordinator
Washington State Dept. of Health

Submitted by Channa Lindsay on

Thank you very much for sharing. We are looking into a similar project to decrease no-shows and improve caseload.

Do you have any suggestions or recommendations as we move forward? Has the education room continued to prove successful? Did the overall client show rate improve?

Thanks for your help!

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Channa Lindsay

Submitted by jsabally on

I love how easy to understand your story board is! I used this as a case study for a WIC QI training and it generated a lot of discussion and was helpful in our staff better understanding the potential of QI. Thank you!

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