While you are waiting for the session to begin, please fill out the Benefits and Challenges card at

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While you are waiting for the session to begin,
please fill out the Benefits and Challenges
card at your table. There is one card per team.
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Business Process Redesign

• Columbus, Ohio
• July 9-10, 2007

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Alaska Dept. of Healthand Social Services

• DPH Business Process Assessment
• Electronic Laboratory Reporting (ELR) Program's
  capacity to effectively monitor ELR data quality
• Capacity to provide ELR for all reporting
  laboratories in Alaska and all major reference
  laboratories outside of Alaska
• Capacity to effectively troubleshoot technical
  (IT) problems related to ELR
• Integrate ELR reporting into new Disease
  Surveillance Mgt. System (DSMS)

Patricia Nault
Lonnie Leibbrand
Gerri Yett-Edmonds
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City of Austin Health Human Services Dept.

• Disease Surveillance Initiative
• Physicians notify department of reportable
  disease at time of suspicion

Jill Schultz
Kurt Becker
Edward Melendez
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Genesee County Health Department

• S.T.D. with I.T.
• (Stop Transmitting Disease with Information
  Technology!)
• Timely and accurate STD reporting
• Decrease number of paper reports coming into GCHD

Denise Kremlick
Susan Hudson
Frank Ricica
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Kane County Health Department

• Building Capacity for Public Health Business
  Process Assessment and Redesign
• Biologic Exposure Incident
• Heat Emergency
• West Nile Virus

Claire Dobbins
Davis Neuenkirchen
Paul Kuehnert
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Louisville/Jefferson County Metro Government

• Increasing Informatics Capacity at the Louisville
  Metro Health Department
• Family planning referral

Priscilla Pursiful
Evette Denise Hudson
Sheila Andersen
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Madison County Health Department

• MCHD Informatics Capacity
• Billing and Accounts Receivable
• Field Nursing

Eric Faisst
Kelley Golley
Shawn Prievo
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Mahoning County District Board of Health

• Environmental Health Permitting Can We Improve
  the Process?
• Septic permitting
• Construction permitting

Matthew Stefanak
Michele Olin
Wesley Vins
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Maricopa County Department of Public Health

• Public Health Clinic Process Redesign
• Family planning clinic
• TB clinic
• HIV clinic
• STD clinic
• Hansen's clinic
• Refugee clinic
• Foreign travel clinic
• Adult immunization clinic

Parvez Kapadia
Corinne Velasquez
Seema Sewell
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Monroe County Health Department

• Seamless Service Integrating Maternal Child
  Health Services
• Women Infants and Children
• Maternal Infant Health

Jamie Leizerman
Rebecca Head
Colleen Hinzmann
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Montana Dept. of Public Health and Human Services

• Information Systems Governance and Planning
  Process
• Have accurate and complete contact information
  for all internal and external partners

Bekki Kirsch
Camie Zufelt
Sue Miller
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Multnomah County Health Department

• Transforming PH Information Systems
• Disease Surveillance for Reportable STDs
• Case/Contact Investigation for Reportable STDs
• STD/HIV/HCV Screening and Treatment.
• Disease and Infection Surveillance for TB
• Screening, Diagnosis, Treatment of TB
• Outbreak/Cluster Investigation

Bill Dalbey
Amy Sullivan
Dan Cole
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University of North Carolina at Chapel Hill

• Developing Business Process Development Skills
  for Public Health in NC
• Restaurant inspections

Wayne Raynor
Teresa Underwood
John Graham
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Santa Cruz County Health Services Agency

• Transforming Information Systems Looking at
  Chronic Disease Information Among Youth
• Chronic Disease Information Among Youth using
  CHDP PM160 Data

Poki Namkung
Leslie Goodfriend
Kennedy Cosker
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Sonoma County Dept. of Health Services

• Redesign of Billing Accounts Receivable
  Processes
• Efficient billing and A/R processes

Peter Denchy
Diana Stornetta
John Wise
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Summit County Board of Health

• Work Interactions Between Food Borne Illness,
  Disease Surveillance, Restaurant Inspection and
  Case Management
• Foodborne Illness Investigation

Carolyn Rose
Robert Swensen
Brent Ovard
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Welcome

• Congratulations on reaching the half-way mark!

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Agenda Day One

• Introduction and Overview
• Selecting Processes for Redesign
• Establishing Measures for Processes
• Identifying the Value Chain
• Closing

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Agenda Day Two

• Ways to Improve Processes
• Change Management and Implementation
• Conclusion

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Timeline
Dec 06
Jan 07
Apr 07
Jul 07
Oct 07
Jan 08
Legend Milestone deliverable Onsite
meeting Conference call
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Timeline
Dec 06
Jan 07
Apr 07
Jul 07
Oct 07
Jan 08
Legend Milestone deliverable Onsite
meeting Conference call
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Timeline
Dec 06
Jan 07
Apr 07
Jul 07
Oct 07
Jan 08
Legend Milestone deliverable Onsite
meeting Conference call
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What is Business Process Redesign?

• Related to CQI, TQM, reengineering, but easier to
  implement
• Changing existing processes to make them more
  efficient and help reach process objectives and
  strategic goals
• Systematic process

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Business Process Redesign Steps

• Choose a process to redesign.
• Identify measures of process quality and
  efficiency.
• Gather data related to measures to establish a
  baseline.
• Identify the purpose of all tasks in the process,
  in order to identify the value chain and possible
  process improvements.
• Brainstorm ways to improve the process.
• Create potential new task flows.
• Involve stakeholders in designing and approving
  new task flows.
• Develop a plan for testing new task flows.
• Implement new task flows and gather data on
  quality and effectiveness.
• Cycle back through process as indicated by
  findings in test.

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Questions so far?
Q
A

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Break 15 minutes
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Agenda Day One

• Introduction and Overview
• Selecting Processes for Redesign
• Establishing Measures for Processes
• Identifying the Value Chain
• Closing

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Selecting Processes to Analyze

• Factors to Consider
• Process condition Is the process well defined?
• Strategic Importance Is the process critical to
  the organizations strategic goals?

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Four Quadrants
Process Condition
Strategic Importance
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LHD Processes

• Immunization
• Communicable Disease Clinical Intervention
  Treatment
• Community Health Assessment
• Environmental (Restaurant) Inspections
• Billing and Accounts Receivable

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Our Processes

• Were the same or similar considerations to
  strategic importance and process definition
  looked at by your agency in selecting business
  processes?
• Are there other business processes within your
  agency that would fall into the critical
  quadrant? Why?
• Do you feel that you could make a case for a
  Business Process Analysis project on one of these
  processes?

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Choosing a Process to Redesign

• Is it inefficient?
• Is it inconsistent?
• Is it antiquated?
• Do we need to document this process?
• Is it feasible and likely that redesign will
  succeed and have a positive impact?

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Questions so far?
Q
A

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Agenda Day One

• Introduction and Overview
• Selecting Processes for Redesign
• Establishing Measures for Processes
• Identifying the Value Chain
• Closing

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Why Measures Are Critical

• Provides objective, quantifiable way to see if
  new, redesigned process is really better than the
  old one.

What can we measure to quantify differences in
performance between the old process and the
redesigned process?
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Balanced Measures

• Customer Outcome Measures
• Voice of the customer
• How is the system performing? What is the result?
  
• Process Efficiency Measures
• Voice of the organization
• How do we know if the process is efficient?
• Balancing Measures
• Looking at a system from different perspectives
• Are changes designed to improve one part of the
  system causing new problems in other parts of the
  system?

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Lunch Break
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Agenda Day One

• Introduction and Overview
• Selecting Processes for Redesign
• Establishing Measures for Processes
• Identifying the Value Chain
• Closing

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Application Processes and Measures

• I Choose a process to redesign.
• II Choose balanced measures.
• III Create a flipchart of your work.
• IV Be a critical friend.
• V Summarize and share your learning points.

• 35 min.
• (with part I)
• 5 min.
• 30 min.
• 20 min.

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Agenda Day One

• Introduction and Overview
• Selecting Processes for Redesign
• Establishing Measures for Processes
• Identifying the Value Chain
• Closing

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Types of Tasks

• Value-added tasks
• Must be performed in order to reach the process
  objective(s).
• Required, non-value added tasks
• Some quality tasks
• Some administrative tasks
• Enabling tasks
• Mandated tasks 
• Non-value added waste tasks
• Some quality tasks
• Some administrative tasks
• Rework
• Handling
• Setup
• Storage

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Break 15 minutes
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Ohio Trivia
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Agenda Day One

• Introduction and Overview
• Selecting Processes for Redesign
• Establishing Measures for Processes
• Identifying the Value Chain
• Closing

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Application Value Chain

• I Identify tasks types for all tasks
• II Label the value chain
• III Pair and share
• IV Summarize learning points

• 30 min.
• 5 min.
• 10 min.
• 5 min.

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Questions so far?
Q
A

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Agenda Day One

• Introduction and Overview
• Selecting Processes for Redesign
• Establishing Measures for Processes
• Identifying the Value Chain
• Closing

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Business Process Redesign

• Columbus, Ohio
• July 9-10, 2007

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Ohio Trivia
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Agenda Day One

• Introduction and Overview
• Selecting Processes for Redesign
• Establishing Measures for Processes
• Identifying the Value Chain
• Closing

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Agenda Day Two

• Ways to Improve Processes
• Change Management and Implementation
• Conclusion

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Symptoms of Inefficiency

• Duplication of effort
• Quality checkpoints too removed from process
• Unnecessary tasks
• Long cycle times
• Data input multiple times
• Excessive errors resulting in re-work
• Participants do not fully understand process
• Process is structured to meet some objective not
  related to the strategic goals
• Process is not standardized

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Principals of Redesign

• Eliminate non-value added waste tasks 
• Streamline non-value added required tasks
• Group administrative tasks
• Perform steps in parallel
• Use multiple versions of the process 
• Minimize handoffs
• Find and remove bottlenecks
• Smooth work flow
• Avoid cumbersome translations and interfaces
• Use automation
• Help all participants in the process feel
  ownership
• Measure outcomes, not tasks or handoffs

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Questions so far?
Q
A

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Agenda Day Two

• Ways to Improve Processes
• Change Management and Implementation
• Conclusion

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Immunization Redesign

• Work in table teams.
• Redesign the immunization task flow.
• Balanced Measures
• Outcome Reduce vaccine preventable disease
  incidence
• Process Increase the percentage of people
  vaccinated
• Balancing Other clinical services are not
  overlooked

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Break 15 minutes
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Agenda Day Two

• Ways to Improve Processes
• Change Management and Implementation
• Conclusion

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Application Redesign

• I Redesign your process.
• II Revise matrix as needed.
• III Create a flipchart of your work.
• LUNCH
• IV Be a critical friend.
• V Summarize and share your learning points.

• 90 min.
• (with part I)
• (with part I)
• 75 min.
• 30 min.
• 15 min.

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Agenda Day Two

• Ways to Improve Processes
• Change Management and Implementation
• Conclusion

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Barriers and Bridges
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Break 15 minutes
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Ohio Trivia
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Agenda Day Two

• Ways to Improve Processes
• Change Management and Implementation
• Conclusion

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Application Barriers

• Generate a list of barriers particular to your
  organization and this process.
• Identify strategies to overcome these barriers.

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PDSA Cycle

• Act
• What changes are to be made
• Next cycle

• Plan
• Objective
• Questions/ predictions
• Plan to complete cycle

• Study
• Analyze data
• Compare to predictions
• Summarize

• Do
• Carry out plan
• Document observations
• Begin analysis

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PDSA Cycle

• Act
• What changes are to be made
• Next cycle

• Plan
• Objective
• Questions/ predictions
• Plan to complete cycle

• Study
• Analyze data
• Compare to predictions
• Summarize

• Do
• Carry out plan
• Document observations
• Begin analysis

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Questions so far?
Q
A

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Common Ground Next Steps

• Informatics Capacity Conference calls
• August 14 at 300 PM
• November (dates to be announced)
• Redesigned Business Processes
• Due December 12, 2008
• Plan of Action
• Due February 1, 2008

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Application Project Planning

• Complete the PDSA worksheet as starting point.
  Add activities as needed.
• Make a detailed plan up to December.

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Questions so far?
Q
A

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Agenda Day Two

• Ways to Improve Processes
• Change Management and Implementation
• Conclusion

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Summary

• Were here to helpcall or e-mail when you need
  support.
• Web sites www.commongroundprogram.org
• www.connectionszone.org
• E-mail commonground_at_phii.org
• Phone [phone]

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Thank You