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Sedgwick County Health Department Storyboard - Purchasing Process

Overview

The Quality Improvement Committee at the Sedgwick County Health Department (SCHD) in Kansas identified improving the purchasing process as one of the eight improvement areas to address in an effort to develop a culture of QI at the agency.
 
The SCHD staff lacked an understanding of the purchasing process, resulting in staff frustration and a number of Charter 57 violations.  These violations were not suspect of ill intentions, so an underlying reason needed to be identified. Many staff supported the need to address this issue, and it was outlined by the quality improvement (QI) team as a priority.
 
AIM Statement
To develop clear instructions and guidance on the major steps of the purchasing process. All clarification/education actions will be implemented by December 2010. Measurements will be made through a simple satisfaction and knowledge survey of various Health Department staff who deal with major purchases. The target audience for these actions will be staff identified by division directors who have a key role in the purchasing process.
 
Plan
A talented group of staff members was assembled to work on this project. Staff included those who work with the purchasing processes regularly and members of the QI team. A work plan and timeline were created, and regular meetings were scheduled. A Gantt chart was created and populated as new tasks developed.
 
A high-level flow chart was created showing the major steps of the purchasing process, as viewed by Health Department staff.  While the purchasing process can be long and tedious with many variables, the teams’ approach was to keep the process as simple as possible. They began by identifying the basic steps from the point of view of the average Health Department staff member who is looking to begin the purchasing process.
 
Do
The process for testing the theory included the actual creation of the Document Repository, along with the education and training of various department staff through division meeting presentations.
 
Once staff were given time to review the information provided and view the high-level flow chart of the purchasing process, time was allowed to elapse, and they were presented a post-implementation survey. This survey was identical to the previous one. Not everyone who took the second survey was able to attend the educational sessions. There was also error in the data in that people took the survey who did not regularly participate in the purchasing process.
 
Study
The new survey data were compared against the previous baseline data, which showed very few changes in many of the survey answers. Review of survey participation showed that numbers and division percentages changed, but they still felt that the results were valid.
 
The educational portion of the project was sharing the flow-chart tool with staff to demonstrate why the purchasing process was confusing. The flow chart was the most essential part in curbing expectations of the process and will continue to be used when staff have questions about the process. 
 
Act
The newly created Document Repository will continue to grow as new information and documents are created. Staff asked for a one-stop location for information, and one now exists; however, the information is, at times, still confusing.
 
The number one lesson learned from the project was that the plan to focus on individuals who actively make purchases for both the surveys and the training was not carried out as hoped. Narrowly directing the survey to only those who participated in the educational sessions would have allowed all theories to have been proven true.
 
Establish Future Plans
The survey results show that more education is needed for staff, as well as more generic outlines for the process. With the frustrations of many staff members still existing, the team has a number of recommendations for future projects. The main recommendation will be to walk a number of purchases through a flow chart to document “issues” that arise and set up projects to address various items. This was one of the original team goals is a long-term project that requires a lot of outside participation and cooperation.

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