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DTMB's process improvement experts assists DHHS with emergency preparedness planning and COVID-19 response

Continuous Improvement Graphic

After eight months, a team from the DTMB Office of Continuous Improvement (OCI) completed their support of the Department of Health and Human Services (MDHHS) COVID-19 Adult Foster Care (AFC) Coordination Team efforts to assist nonskilled nursing home providers with their emergency preparedness planning and COVID-19 emergency response.

The team from OCI provided their services as part of a task force focused on the 5,000 nonskilled nursing home providers in Michigan. These ranged from professional multifacility providers to small “mom and pop” providers taking care of a family member.

The OCI team specializes in looking at large projects and providing suggestions to make them more efficient. As a standard practice within the state of Michigan, LEAN process improvement is requested for projects requiring coordination across bureaus and departments. It is also policy to always review any IT projects with an estimated budget over $2 million dollars.

“Because we have an outsider’s perspective, we can take an objective approach to facilitating work,” State Administrative Manager Brett Gleason said.

Gleason leads a team of four at OCI. Together, they focus on creating and assisting with statewide methodologies for improving project efficiency within primary state agencies. Using those methodologies for project organization, in conjunction with principles of employee engagement and change management, the team created an infrastructure for the AFC Coordination Team that would prompt creative problem solving and allow leadership to make informed decisions quickly.

The COVID-19 AFC Coordination Team was able to comprehensively address the challenges posed by COVID-19 through a variety of tools. The team created emergency staffing strategies for facilities encountering staffing shortages and opened additional Care Recovery Centers to better meet the anticipated demand of residents requiring transfers. To communicate these strategies to care facilities the team held webinars providing the most up to date information. The webinars also served to connect care facilities with pharmacy partners distributing the COVID-19 vaccine.

“These were complex problems that required different voices and bringing everyone up to speed on the nuances of each individual challenge,” Gleason said.

Providing comprehensive information to the nonskilled nursing facilities meant fostering partnerships between the Michigan Department of Health and Human Services, Department of Licensing and Regulatory Affairs, and the Michigan Occupational Safety and Health Administration. Working together with the departments, the AFC Coordination Team was able to streamline the state’s voice and mitigate conflicts between emergency orders, epidemic orders, and licensing requirements.

In addition, bringing together a variety of professionals in a remote work environment to tackle project goals that required urgent attention posed a variety of challenges.

“One of the challenges of this particular project was figuring out how to quickly establish relationships in a virtual setting,” Gleason said. “You might have 25 people on a call. And our goal was not just finding solutions to problems, but also to create a working relationship between team members, because it will be necessary to leverage those relationships to get the work done for something that was needed the next day.”

Because of the diverse types of long-term care facilities, subject matter experts generally specialize in a specific subcategory of nonskilled nursing homes. When it came to maximizing the efficiency of the task force’s resources, bringing a diverse set of experts together to find solutions was necessary.

After months of work, Gleason and his team were able to streamline the efforts between the various government offices and, ultimately, assist the employees working in long-term care facilities to serve their residents during the pandemic and beyond.