Special Thanks…. Debra Isaac, Customer Service Supervisor – Vital Statistics Cheryl M. Williams, Deputy Registrar – Vital Statistics Simon Trevino, Senior Computer Operator – Vital Statistics Vital Statistics Cashiers Luis Carrillo Mary Coutee Esmeralda Gonzalez Cathy Grant
Celina Garza Ridge
“Quality improvement in public health is the use of a deliberate and defined improvement process, such as Plan-Do-Check-Act, which is focused on activities that are responsive to community needs and improving population health.
It refers to a continuous and ongoing effort to achieve measurable improvements in the efficiency, effectiveness, performance, accountability, outcomes, and other indicators of quality in services or processes which achieve equity and improve the health of the community.”
Defining Quality Improvement in Public Health; Journal of Public Health Management & Practice: January/February 2010 - Volume 16 - Issue 1 - p 5–7, Riley, William J. PhD; Moran, John W. PhD, MBA, CQIA, CQM, CMC; Corso, Liza C. MPA; Beitsch, Leslie M. MD, JD; Bialek, Ronald MPP; Cofsky, Abbey -
The continuous improvement
phase of a process is how you
make a change in direction.
The change usually is because
the process output is deteriorating
or customer needs have changed
Today the most progressive view of quality is that it is defined entirely by the customer or end user and is based upon that person's evaluation of his or her entire customer experience.
The customer experience is the aggregate of all the Touch Points that customers have with the organization’s product and services, and is by definition a combination of these. (RFT)
“Quality is not an act. It is a habit”
Aristotle 384BC-322BC, Greek philosopher and scientist, student of Plato and
teacher of Alexander the Great
Begins with: Customer receiving ticket # from info desk
Ends with: Customer call to cashier window
Customer Wait Time: Unknown
Is a correct application section complete and required documentation available?
Complete correct section
Leave if cannot complete form or missing docs
Customer Wait Time
Avg.: 28 min
Call # Assigned
Is application information correct?
Obtain Correct Information
Sent to Printer
Customer Wait Time, includes SOD certificates Avg.: 7 min
Print Window Call
Pick up Certificate at window #10Flow Chart
Wait time of 28minutes for vital statistic customers
Dist of tasks, responsibilities
7. Develop Improvement Theory:
Create trigger system for supervisor to
improve customer flow.
Maintain wait time to 15mins.
1. Identify / Prioritize Opportunities:
Customer average wait time
more than 28 minutes
8. Develop Action Plan: Pilot Program –
One additional cashier added from
Correspondence and additional cashier/s
when wait time exceeds 15 minutes
1. Reflect on the Analysis:
Data obtained for wait time - 1 Week
pilot program. Cashier Survey data
2. AIM: Reduce customer
wait time to 15 minutes
2. Document Problems: Unavailability of
Staff and Communication issues.
Observation: Smooth running of pilot
Lessons learned: Customer Wait time
to # of cashier window open
3. Current Process:
Limited number of cashiers
to process transactions
1. Implement the Improvement:
Implementation of Pilot
Program for a week
4. Collect Data On: Number
of cashiers and the wait time
5. Identify Possible Causes:
No. of cashier windows open,
Incomplete documentation etc.
2. Collect and Document the data:
Wait time reduced by 50%
3. Problems, Observations, Lessons Learned
Pilot Program Implementation
Day 1: Ran a snag – 4 staff out
Day 2: Successfully implemented Pilot
Program (5 cashier windows open)
Day 2-5: Pilot Successfully implemented
6. Identify Potential Improvements:
Increase the number of cashier
windows open(especially at rush hour)
Houston Department of Health and Human Services (HDDHS) aims to reduce Vital Statistics customer wait time.
HDHHS Vital Statistics currently experiencing average customer wait time of 28minutes. Among the reasons for these difficulties is few cashier windows open to serve customers.
Short term Medium Term Long Term
QI STAR Trak Team
trigger modules for
and staff roles
program for 1 week
and Staff of
partners and other
of pilot program
Pros and Cons
of Pilot program
after studying the
pros and cons of
and fine-tuning the
program , maintain
reflect job well
done by HDHHS
usage of available
ability to serve
customers in timely
to instruct supervisor/s on available resources that can be implemented to reduce customer wait time and assist them to adopt multiple trigger modules to use the available resources. Avenues created are flexible to accommodate all barriers.
Vital Statistics will work collaboratively
to implement the project
Staff feels alienated, incentives not good
enough to motivate and organizational bureaucracies.
Demonstrate measureable improvement in Vital Statistics customer wait time. Customer Feedback Survey
And Cashier Feedback. Increase in customer satisfaction to access HDHHS Vital Statistics resources.
Bureau of Vital Statistics - Cashier Feedback
STAR Trak (Blue Team) Pilot program initiative
(To be completed by Cashier)
Cashier Initials (optional): _________________________________________________
Cashier Work Days and Hours: _____________________________________________
Did you like the STAR Pilot Program Initiative? Yes/No: _______________
Why? (please provide details): ___________________________________
Please provide any suggestion/comments to improve the program:
Thank you for your participation!
Cashier Feedback (N = 6)