Carelink Community Support Services of Pennsylvania, Inc. is a 54 year-old non-profit agency that provides social, vocational, and rehabilitative services to individuals with intellectual disabilities. The agency employees 350 people who work throughout the five southeastern Pennsylvania counties. Services are provided at 22 different residential homes and on the grounds of the Norristown State Hospital. The consumers with mental disabilities live at the Carelink locations and staff provides care 24 hours per day, 7 days per week. The billing function is an area that needs to be streamlined. Currently, staff provides services, handwritten notes are taken, these notes get typed into the computer whenever the staff person has time, the notes are then entered into a software program called ETO, the Accounts Receivable clerk accesses ETO to run a report to see how many consumers were given services for the month, the Accounts Receivable clerk then types this information into excel, and then e-mails the spreadsheet to the respective county for payment. Several types of waste are evident with the current process. There is grave overproduction with the note process, as notes are taken multiple times and entered into the computer twice. Once when the staff transcribes them into Word or Notepad from their handwritten form and once when they are entered into ETO. This leads to waiting imposed by an inefficient work sequence since not all program staff completes their notes at the same time. All of the note taking and entering does not add value because the Accounts Receivable clerk has no way of knowing if all consumers are accounted for and if all information entered into ETO is accurate and up-to-date. Lastly, invoicing the county using excel seems archaic. The main problem that needs to be targeted is the elimination of waste in the note taking and note entering function. Carelink management, together with staff level personnel should determine what types of notes are really needed. They can start by asking who needs access to the notes and who utilizes the notes. For those that access and utilize the notes, what is it that needs to be seen? Are there county regulations that have to be adhered to? What are the licensure requirements? After these questions are asked, a template can be created to capture the pertinent information. This standardization will enable Carelink to reduce input variety. Carelink will see a more efficient process with the notes, accuracy and quality of the notes will increase, there is an easier transition for staff members when they have to cover for others, and staff time is freed up to focus on what Carelink’s mission is, which is serving consumers with intellectual disabilities.
Another element of improvement that agrees with JIT principles is the use of databases and technology. Carelink needs to evaluate whether the ETO system is a good fit for the organization and if it is providing what it is intended to provide. The system relies on too much data entry. An up-to-date, “real time” piece of software can drastically change the scope of how information flows at the agency. The IT department should work closely with the other departments to design or buy a system that will satisfy multiple functions. Carelink should ask staff what sort of information they want to have available and figure out which departments are responsible for providing it. There is no reason not to have a system that can satisfy various departments’ demands and that can be accessed remotely. A technologically advanced information system will allow for economies of scale, specialization, clear boundaries of responsibility, and concentration of expertise and training. Some safeguards would have to be implemented to ensure that the employees are not exposed to the risk of mistakes, such as the incorrect diagnosis codes being entered, daily logs not being completed,