Reducing waiting time, one change at a time: Green County Human Services

“It’s hard to know who to talk to or what to ask for.”

That’s what Lisa Marty, MSW, CAPSW, discovered recently when she called the agency where she works, Green County Human Services in Monroe, Wisconsin. She was conducting a NIATX walk-through, pretending to be a client seeking services.

Lisa works as a service facilitator (case manager) at the agency’s Comprehensive Community Services (CCS) division. The walk-through was part of the pre-work required for the Spring 2016 NIATx Change Leader Academy that Lisa attended with Sharon Farrey, CCS Director, and Laura White, board member.

Says Lisa, “With our NIATx project, we want to work on make it easier for people to understand what we offer and on getting services to people when they need them.” 

Green County is in southern Wisconsin, sharing a border with Illinois. This rural county boasts the highest number of cheese factories in the state, natural beauty, and miles of great biking trails. Like many areas of the country, Green County has felt the impact of the opioid misuse epidemic. Green County also has one of the highest rates of alcohol-impaired driving in the state.

Green County Human Services offers a wide array of social services for Green County residents. The CCS division offers mental health services for people with persistent mental illness, along with case management services for people who need more intense support. 

“The walk-through reinforced our commitment to providing quick access to care for people who are experiencing persistent mental health symptoms,” says Lisa.

Lisa and her colleagues are new to NIATx, though the agency has worked on improvement projects using other methods in the past.  

What attracted them to the NIATx Change leader Academy?

“We liked the idea of making small changes that could enhance our programs and improve customer access to our services,” comments Lisa. ““We also liked the idea of connecting with others working on the same issues. The two-day face-to-face workshop included a lot of brainstorming with others about what might work best in our program.”  

After attending the face-to-face workshop in Madison, the team returned to their agency with tools for creating a change team, setting a change project goal, and conducting PDSA Cycles.

Sharon, who is also the director of CCS, is the executive sponsor for the project.

Lisa is the change team leader, leading a diverse team that includes two caseworkers, a therapist, and board member Laura White.  Adds Lisa, “Laura is also a consumer, giving our change team the customer perspective.”

While finding time to meet can be a challenge for some change teams, this team will meet as part of an established weekly staffing meeting.

The NIATx Change Leader Academy includes monthly coaching calls that continue for six months after the in-person trainings. These calls allow continued peer networking as the change leaders-in training share their progress.

Lisa and her team shared their newly minted aim statement during the a recent coaching call: 

Reduce referrals wait time to CSS services from 30 days to seven days.

To achieve this aim, the team will test one change: allocating time each week for caseworkers to work on referrals. 

“In the past, we would work on referrals one at a time as they came in, and they often got set aside as more urgent issues arose,” explains Lisa.  “We think this was contributing to the long waiting times to treatment.”

To measure the effectiveness of this change, the team will use a simple Excel spreadsheet to document days between referral and treatment admission.

Amy McIlvaine, Educational Services Director for NIATx, advised Lisa and her team to add a time frame to their aim statement.

 “One thing that scares people when they start a change project is that it’s never ending,” says Amy. “That’s why it’s always a good idea to include an end date in your aim statement.”

With that in mind, the team as set a six-month time frame for this change project. They’ll be collecting data through November 2016, testing a series of changes along the way.

NIATx coach Mat Roosa endorsed this team’s plan to test and measure one change at a time—a weekly schedule for caseworkers to work on referrals.

 “By testing one change at a time and measuring it, the team will be able to see pretty quickly if it’s influencing waiting time.” 

Lisa and her team will share their progress on the upcoming coaching calls.

Says Lisa, “We appreciate that the NIATx Change Leader Academy makes time for consistent check-ins and feedback on our change project.”