HJBR Nov/Dec 2019

LDH 22 NOV / DEC 2019 I  Healthcare Journal of BATON ROUGE   them to earn a Yellow Belt certification. The Yellow Belt status allows the trainee to become familiar with the foundations of the Lean Six Sigmamodel, but it also helped cre- ate buy-in fromdepartment leaders, some of whomwould be asked to allow teammem- bers to take time away from their regular jobs to complete the more rigorous Green Belt training that would allow them to lead their own projects. After the initial round of training, departmental leaders selected 14 LDH team members to begin their Green Belt training, a course that teaches how to define a problem, and how to collect data andmeasure progress as possible solutions are worked out. The course also schools trainees in how to analyze various parts of the problem, and to design a solution in response. Following training, each Green Belt team member took on their own proj- ect and was able to put together a team that helped analyze and implement solutions. Clara Hudson, a quality assurance programmonitor in the department’s Office of Aging andAdult Services, took on a proj- ect that looked at why LDH was missing goals for approving Medicaid applications for people entering nursing homes across the state. The end goal was to ensure that people who apply for Medicaid to cover long-term care get a timely decision. Hud- son said her team was able to identify the problem fairly quickly: Application deci- sions depend on paperwork being scanned into the system, and scanning takes time— sometimes a couple of hours per application. Rather than hire more staff to mitigate that problem, Hudson said the team wanted to thinkmore creatively, so they came upwith a pilot program to circumvent the need to hire more people. “We created a partnershipwith someMedicaid analysts and a small group of nursing facilities that allowed the facilities to tell the analyst which application needed to be worked,”Hudson said. The analyst would become the single point of contact for the nursing home, and if the facility needed a decision on a patient more quickly, it could call the analyst directly and have that appli- cation located and scanned. A key step in the process was identified as taking too long: 91 percent of the time, that stepwasn’t being completed in five days or less. After the team completed the pilot program, that step only missed the five- day goal 5 percent of the time. “The pur- pose of the pilot is to show it does improve the amount of time it takes to process an application if we have a partnership between the analyst and the nursing facilities,”Hud- son said.Another goal was to, “make it easier for the people we serve, and make it easier for the people doing front-line work.”Hud- son said she is hopeful that LDHwill be able to scale up the process to includemore nurs- ing facilities and work it into standard oper- ating procedures. Christina Bolton, the quality man- agement and improvement director at The Lean Six Sigma team that led the pilot to improve quality in recruitment for the Louisiana Department of Health poses for a photo.