Faster and More Effective Reporting of Complaint Data—Gisela Polo, VNSNY’s CCSS Member Services Director

A Process Improvement Project Summary

Gisela’s process improvement project focused on the tracking and dissemination of data on same-day grievances (SDGs) related to CHOICE plan members. SDGs are complaints that are called in to a CHOICE Member Services Representative (MSR) and resolved all in the same day. Example: A home health aide who didn’t get the supplies she needed for a client.

The problem: Gisela felt that the process of writing reports on each complaint was taking too much time, and that the most important data—which would allow CHOICE management to spot problems, track trends and make needed changes—wasn’t always making it into the reports. “Everyone involved knew this was an issue,” she says. “It was a question of identifying the pain points and getting everyone on the same page.” Among other things, the documentation process was unnecessarily complicated, resulting in too many mistakes and too much back-and-forth with MSR’s to correct them. Proper coding for the New York State Department of Health, which receives summaries of all CHOICE complaints, was also a constant problem.

The solution: Based on Gisela’s analysis, a number of changes were made to the SDG process, including revisions to the reporting format that made it easier to navigate and better reflected the relevant complaint categories. The MSRs’ weekly reports were also reformatted to make them more user-friendly. CHOICE MSRs quickly embraced these changes, seeing how they simplified the department’s workflow and reduced the time needed to complete some of their tasks.