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June 15, 2008
VENA and the WIC Clinic
Have you wondered how VENA is affecting your clinic environment? Has it made a positive or negative impact? How has it affected your clients? What is your perception about VENA? You may be wondering, why so many questions? These questions are being asked to evaluate VENA implementation. This article has results from a few Patient Flow Analysis (PFA) studies and provides insight into how VENA is impacting our Texas WIC clinics. We hope you find this information helpful.
Anna Garcia, Program Specialist at the State Office, coordinated PFA pre-VENA and post-VENA studies. Eight local agency clinics participated in the project. The clinics were selected due to their experience and commitment to PFA. The clinics varied in size which provided a good representation of WIC clinics statewide. The studies focused on two areas: 1) the amount of time it takes to counsel a client and 2) the total time it takes to process the client through a certification appointment from the time of arrival until the client walks out with food benefits.
Each clinic was asked to conduct a PFA study within one year prior to VENA implementation (pre-VENA) and another study after VENA implementation (post –VENA). In the pre-VENA study the first variable, “counseling”, included reviewing/scoring the dietary recall and providing individual counseling. Staff took an average of 8 minutes to counsel the client. In the post-VENA study, “counseling” included initiating the conversation, identifying the client’s concern, and educating the client. It took staff an average of 10 minutes to perform these tasks. The difference between the two studies was two minutes.
The second variable, total amount of time it takes to process a client through a certification appointment took a total of 59 minutes in the pre-VENA study and 48 minutes in the post-VENA study. The difference is eleven minutes.
Local agency staff have voiced that VENA takes longer. The results of these PFA studies indicate implementing the VENA style of counseling may add two minutes to the counseling session but decreases the certification processing by eleven minutes. How can two minutes save eleven minutes? The results may be surprising. When clients’ concerns are addressed, they may be more cooperative and attentive during certification resulting in a smoother flow through the process. The conversations may flow better due to the client being interested in the topic and hopefully seeing the certifying authority (CA) as a good resource for nutrition information. How wonderful a client must feel when she gets the information she was interested in and gets the added benefit of leaving the clinic eleven minutes quicker.
These studies have demonstrated that although some staff may be concerned that implementing VENA causes a client to have a longer appointment due to the long counseling sessions it actually results in an overall decrease in the amount of time needed to process the client through the entire appointment. When evaluating the processing time of our clients it is important to find out what is truly happening instead of making assumptions about what is happening. If it takes an extra two minutes during the counseling session to get a client to voice a concern, for staff to build rapport with the client, or to provide the education the client was searching for, it is time well spent. The clinic environment has been positively affected with hopes that all clients will one day voice their nutrition concerns and refer to WIC as their nutrition education resource.