disability and health supports unit request inbox kaizen · • push systems hide in office work...
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Families
Disability and Health Supports Unit Request Inbox KaizenDecember 12th and 13th, 2018
February 21 – CME Kaizen Conference12019-02-21 FAM DHSU - CME Kaizen Conf 2019
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Families What does the DHSU do?• Department of Families: one of the
largest departments with ~2,000 employees
• The DHSU is a centralized unit of 11 employees that provide disability and health-related supports to Manitobans who qualify for assistance
• The DHSU:– Provides funds directly to individuals (eg.
for purchasing special dietary needs)– Approves the purchase and delivery of
equipment and supplies (walkers, wheelchair seating components etc.)
• The DHSU reviews about 10,000 requests/year
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Families What does the Request Sorting Process involve?• Requests
– Are received via email to a central e-mail address
– Have an initial review for eligibility and completeness of request
– Are separated into two categories: Diet/Supplies and Equipment
– Are logged in a central database– Are emailed directly to the
employee who will assess the request
• Selecting the employee to receive the request is determined by: – Type of request (diet/supplies or
equipment) – Caseload distribution for staff: by
requestor last name or home area– Which employee has engaged with
this requestor in the past
32019-02-21 FAM DHSU - CME Kaizen Conf 2019
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Families What did our process performance look like before?
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The data shows a two-peak distribution of Turn Around
Time performance!
This resulted from our separation and
prioritization of the two types of requests at intake
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Families Delays in our process mean delays in providing our clients support• Hospital discharges of clients
requiring wheelchairs, walkers, or crutches– This can delay a hospital discharge,
impacting other clients waiting for a bed!
• Individuals living at home without mobility devices or bathing equipment (grab bars, bath chair)– Safety risk– Lack of independence in self-care
• Low-income individuals with special dietary requirements prescribed by their doctor– Health risk if they can’t afford to
purchase costlier food or supplements
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Families Process Map - Current State
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• The process split into two streams along the major request groupings– These two streams had very different performances
– Batch processing on one stream had a huge negative impact on performance
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Families Problems, Issues and
Observations• Defects
– Follow up needed due to errors and incomplete forms
• Waiting– Taking too long to forward requests from inbox
• Travel– Email histories were locked to personal email
boxes and not accessible
• Inventory– Duplicating statistics
• Extra-Processing– Unnecessary information put in emails and
spreadsheet
• Overburden– Workload distribution was unbalanced between
staff receiving the requests
• Unevenness– Different processes for different staff and request
types – Batch processing– Inconsistent staffing on inbox
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Families Process Map- Improved State
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Current State
Improved State
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Families We found tons of opportunities!
• We worked to eliminate process waste and to improve consistency by adding standards where none existed
• We recognized that a dedicated resource at the front end of the process was key
• We decided to shift from our “push” system to a “pull” system and eliminated many categorization methods as a result– We had to expand our scope
beyond the request sorting process to fix the batch processing problems
– Moved to a FIFO system– Finished a request? Take the next
one!– Required cross-training of our
people
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Families
2019-02-21 FAM DHSU - CME Kaizen Conf 2019
It’s working!
10
0
50
100
150
200
250
SameDay
2 3 4 5 6 7 8 9 10 11 12 13 14 +
Number of Days to Process Request
Before Kaizen After Kaizen
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Families Implementation
11
Task Due Date Done?
Quick Hits
Stop tracking individual statistics on number of requests
processed Immediately✓
Gems
Develop SOP for inbox (include distributing emails with FIFO
and scanning hard copy mail daily
Jan 4, 2019 ✓
Create new inboxes to support pull system Jan 11, 2019 ✓
Train 1st staffing group to be able to pull any type of work Feb 1, 2019 ✓
Education for stakeholders regarding this restructuring Feb 22, 2019
Strategic
Permanent fulltime position for DHSU inbox Summer 2019 ✓
FIFO rules for 2nd staffing group to move to pull system &
cross train to be able to pull any type of work
Summer 2019
Create on-line applications Jan 2020
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Families Our lessons learned
• Challenge “why” we do every step of a process if you want to improve it!
• Push systems hide in office work everywhere– Whenever you divide up work by
categories, you may have a push system
– A pull system needs trust between management and staff to work!
• Batch processing might feel more efficient to an office worker, but you make your customer wait
• Standardization of work is critical when multiple people are involved
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Families Thank you for listening!
Questions?132019-02-21 FAM DHSU - CME Kaizen Conf 2019