Chapter 4: Productivity and Efficiency
Timeliness
One indicator of timeliness used is elapsed time – or the number of days between an event and the posting of documentation in the CONNETIONS system regarding that event, or the length of time necessary to close a case. If we look at the age of cases, for only those cases that opened and closed within the pre-pilot period (April 28, 2007 – July 20, 2007) and the during-pilot period (July 30, 2007 – October 19, 2007), we see a picture which demonstrates timeliness increases. The trend line during the pilot shows a marked increase in cases closed within approximately the first seven days and the percentage of cases closed is higher overall by approximately 10 % over the pre-pilot figures. The pre-pilot trend line also shows a steep increase as it nears 60 days and this may represent CPS workers playing “catch-up” in order to meet the required time frames. With the technology, the days approaching 60 days is much smoother and reflects less of an accelerated “catching-up” process.
Graph 8 - Age of Cases When Closed
Table 2 below represents the percentage of safety assessments submitted over a seven day period. Very few safety assessments are submitted on the same day the cases investigation opens. This is as expected given that completing a safety assessment requires multiple tasks to be completed, such as visiting the home and contacting individuals. Three-quarters of the safety assessments (74 % pre- and 74 % during) are submitted by day seven for both the pre- and during-pilot periods.
Table 2- Percentage of Safety Assessments Submitted Within 7 Days
| |
Same day
4 days
|
1 day
5 days
|
2 days
6 days
|
3 days
7 days
|
|
Pre |
During |
Pre |
During |
Pre |
During |
Pre |
During |
|
Percent of all safety assessments submitted |
.09 |
.14 |
3. |
2 |
8 |
9 |
15 |
17 |
|
Number of safety assessments |
1 |
1 |
31 |
17 |
55 |
45 |
76 |
63 |
| |
Same day
4 days
|
1 day
5 days
|
2 days
6 days
|
3 days
7 days
|
|
Pre |
During |
Pre |
During |
Pre |
During |
Pre |
During |
|
Percent of all safety assessments submitted |
24 |
27 |
35 |
38 |
52 |
53 |
74 |
74 |
|
Number of safety assessments |
95 |
67 |
116 |
86 |
182 |
109 |
230 |
152 |
With 75 % of safety assessments submitted by day seven, that leaves 25 % for improvement and a chance for some technological impact. However, 95 % of all safety assessments are submitted by day 14 after the start of a case (95.2 % pre-pilot period; 95.6 % during-pilot period). Too many factors may be at play here to expect the technology alone to improve timeliness, including tracking down clients or waiting for information from other parties.
We also looked at the elapsed time between progress note entry and the related event. During both periods, approximately half of all progress notes are entered on the same day as the event, and approximately two-thirds are entered within one day after the event. In addition, three-quarters of all progress notes are entered by three-days after the event. We would have expected the proportion of notes on the same day, next day, and second day to increase from the pre-pilot periods. However, there were not overall increases in the proportion, indicating no productivity gains in the reporting process. In addition, if three-days is considered contemporaneous, that leaves only 25 % of all notes where technology impacts may help to improve timeliness.
Table 3- Percentage of Notes Submitted Within 5 Days
| |
Same day
3 days
|
1 day
4 days
|
2 days
5 days
|
|
Pre |
During |
Pre |
During |
Pre |
During |
|
% of all notes entered |
50 |
50 |
66 |
65 |
71 |
70 |
|
Number of notes entered |
10348 |
8608 |
3469 |
2713 |
1047 |
890 |
| |
Same day
3 days
|
1 day
4 days
|
2 days
5 days
|
|
Pre |
During |
Pre |
During |
Pre |
During |
|
% of all notes entered |
76 |
75 |
80. |
79 |
83 |
83 |
|
Number of notes entered |
1085 |
884 |
792 |
657 |
591 |
586 |
There are some slight differences between field offices with Manhattan more able to get progress notes in by the first day, but Staten Island testers catch up by day two. In Manhattan, about half of all progress notes were entered on the same day before and during the pilot (52 % pre-pilot; 51 % during-pilot) and about two-thirds were entered one day after the event (68 % pre-pilot; 65 % during-pilot). In Staten Island, about half of all progress notes were entered on the same day (47 % pre-pilot; 49 % during-pilot) and almost two-thirds were entered one day after the event (69 % pre-pilot; 65 % during-pilot).
Graph 9 focuses on elapsed time and plots the percentage of all notes entered by days from the note entry to related event for each field office. Overall, the same pattern is present as above – no substantial technology impacts on timeliness of progress notes is apparent for each field office.
The information we gathered from surveys and workshops may shed some light on these patterns. First, timeliness is impacted by individual work styles and caseloads. Some individuals were very timely before the introduction of technology, and some were not. Some supervisors reported seeing substantial improvements in productivity in some testers. The introduction of technology appears to affect individuals differently and the aggregate results are that modest gains by one person is adjusted by modest losses for another person. One caseworker stated, “Even though the laptop makes case notes entry a lot easier, because I am able to access CONNECTIONS from anywhere, as long as a signal is available, there is still the issue of the caseload size as well as some of the individual cases and the type of family and their issues that we have to deal with.”
Graph 9 - Percent of Notes Entered by Day After Event by Field Office
CPS workers in the workshops described working with their supervisors to close a case while the worker was in the field, and being able to enter the information the supervisor needed to close the case. While, changing overall work habits may not happen in a 12-week pilot test, these experiences represent positive work changes.