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APHA Scientific Session and Event Listing

Recorded presentation

Nick Macchione, Deputy Director, Health & Human Services Agency, 8965 Balboa Avenue, San Diego, CA 92130 and Carol Judkins, RN, PHN, PhDc, Chief Public Health Nurse, County of San Diego, Health & Human Services Agency, 1700 Pacific Hwy, Suite 301, San Diego, CA 92101, (619) 515-4207, carol.judkins@sdcounty.ca.gov.

In 2005, the County of San Diego Health and Human Services Agency (HHSA) developed the Mobile Remote Workforce (MRW) Business Process Reengineering Pilot Project with the goal of streamlining and improving service delivery in the field. Home visits to at-risk families with infants and children by public health nurses was selected as the project focus.

Before the pilot project, extensive mandatory case narrative and other manual documentation, incomplete and inaccurate referrals, scheduling, travel time, and other administrative functions limited the amount of time available for public health nurses to perform additional customer care. The MRW pilot project reengineered the day-to-day work processes for public health nurses and introduced cutting edge remote-based technology that expedited the intake process and reduced administrative tasks.

The completed pilot project has achieved a 75% reduction in the time elapsed between case referral and customer contact and a 25% sustainable increase in productivity of public health nurses in the field. This translates to an estimated 2,400 additional clients per year when the pilot is fully implemented countywide and anticipated cost avoidance (savings to taxpayers) of approximately $8.5 Million within a 3 year period. Further implementation of this transferable innovation to other County departments and programs is expected to further improve cost effectiveness, increase efficiency and enhance customer service.

In summary, the MRW is a major business innovation that represents a state of the art approach for filling gaps of existing services in a large and diverse geographical region. This leads to measurable increases in prevention. Further, the added service capacity assists more families with at-risk children while avoiding significant amounts of local, state and federal government costs. An independent performance evaluation by the UCSD School of Medicine verified measurable results consistent with acceptable governmental and financial management practices and promoted general governmental accountability.

Learning Objectives:

• How implementing business process reengineering can improve health and other government services for customers.
• How an engaged health care workforce within a highly unionized environment can accept organizational culture change that sustains innovation and continuous improvement.
• How technological enablers can enhance operational priorities in achieving client solutions.

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation