An Initiative to Improve a Local Health Department's Lyme Disease Case Report Process


Impact Statement: 
Responding to case reports of Lyme disease, the most common tick-borne infection in North America represented a very large time burden for a local health department in northwest New York state. The department used QI tools to decrease the number of steps and amount of time to respond to case reports by using a completely electronic process. This time savings will allow for greater RN time to educate the public and patients about Lyme disease.

The aim of Jefferson County Public Health Service’s quality improvement (QI) project was to reduce the number of possible steps in the Lyme disease case report process from 41 to 18, to transition from a combined paper and electronic process to a purely electronic process, and to reduce the types of staff involved in the process from two to one. The project began on January 2, 2013, and concluded on July 31, 2013, with adoption of the new process.

The QI team achieved significant process improvement. The improvement theory was tested across two cohorts of Lyme disease case reports. The number of days it took for staff to process a Lyme disease report decreased by 20%. Time (in minutes) to process a Lyme disease report showed similar improvement. In testing the first cohort, the process was made fully electronic, and the need for secretarial staff was completely eliminated. Time (in minutes) was reduced by 51.9%. In testing the second cohort, time was reduced to 5.68 minutes.

The improvement in time, based on comparison of the old approach with the new approach, represents a 73.3% reduction in minutes that registered nurses (RNs) worked per Lyme disease report. Although the team met its goal of reducing total possible steps in the process, actual total steps were reduced by 73.5% on average.

Organization that conducted the QI initiative: 
Jefferson County Public Health Service

Jennings, S. Public Health Quality Improvement Exchange. An Initiative to Improve a Local Health Department's Lyme Disease Case Report Process. Mon, 01/29/2018 - 14:27. Available at Accessed July 25, 2024.

Submission Status: 
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cgizzi's picture
Submitted by cgizzi on

I very much appreciate your "lessons learned" section. So often with public health QI projects, we go into them thinking we know what the problem and solution are, but then the data and QI methods lead us to realize something different. This is a great example of how you let the data and QI process guide you to make real improvements. I also loved your comment about staff empowerment. Nice work!

Cindan Gizzi, MPH
Community Assessment Manager
Tacoma-Pierce County Health Dept.

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Grace Gorenflo's picture
Submitted by Grace Gorenflo on

Truly outstanding results - thanks so much for your submission!

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Submitted by lkent on

It's great to read that the process improvements are being applied in other disease-reporting processes. Fantastic! Keep up the good work!

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