Vaccine Inventory Management Rapid Improvement Event

The clinic administrator initiated the need for an RIE and organized all aspects of the process. During the event, the facilitators used the A3 lean tool to organize, work through, and document the quality improvement (QI) project. The group used process maps to determine current and target states. In addition, the waste walk helped determine root causes and identified areas for improvement. A 5-whys excercise was done to determine what our root causes were. A prioritization matrix was used to determine which QI projects to focus on. Projects that had a high impact on the staff and required a lower level of effort were chosen to be completed during the 3-day event. The group did several rapid experiments during the RIE (e.g., alphabetizing and color-coding the vaccine refrigerator and lot number list). Another group focused on improving the consent forms, creating new labels for the routing sheet, and writing standard procedures for billing. The consent form was tested for one week to identify problems or errors. Our new sticker was tested for an afternoon with direct feedback from staff. The ordering process was updated using best practices from Denver Health, which involve par levels, an electronic inventory system, and standard vaccine ordering procedures. Color coding of the refrigerator was tested with part-time staff to see if it was easier for them to find vaccines that they are looking for.

DPH staff measured the QI initiative in four ways: financial, ordering, quality assurance, and employee satisfaction. Staff measured the financial impact by the increase in donations after implementing standardized scripting for nurses. Staff reviewed the frequency of vaccine orders per month compared with previous years. Staff reviewed the nurse documentation error rates and employee satisfaction using an online survey at 45 and 90 days after the RIE. Staff also conducted a return on investment (ROI) analysis after the RIE.