Used to be, U.S. Naval Academy Midshipmen on Induction Day in need of immunizations were forced to deal with long lines, longer waits, and redundant red tape.

Not anymore.

Petty Officer 3rd Class Kayla Kirk, from Bend, Oregon, currently assigned to Naval Hospital Bremerton as Urgent Care Clinic assistant leading petty officer, was part of a Lean Six Sigma (LSS) team that conducted a quality improvement project which not only effectively reduced time spent on providing vaccinations, but lessened staffing needs and sped up the entire process for all patients involved.

The LSS team was comprised of Dr. Jitendrakumar R. Modi and Ensign Chrysanthy Ha from School of Medicine, Uniformed Services University of the Health Sciences; retired U.S. Air Force Master Sgt. Donald A. McCoy from Navy Medicine East; and Capt. Robert S. Fry, Kirk and Petty Officer 3rd Class Christopher B. Taylor of Naval Health Clinic Annapolis.

Kirk was recently recognized with a Navy Letter of Appreciation (LOA) by Capt. M.B. McGinnis, Naval Health Clinic Annapolis commanding officer, for her "knowledge and effort" in helping to streamline the requirement of providing inoculations to incoming "plebes."

Kirk was noted to have significantly impacted the overall process, decreasing the steps taken by 79 percent and process times by 75 percent as vaccinations for approximately 1,200 new midshipmen were administered with a mass immunization procedure during the in-processing period.

McGinnis cited the "LSS team's ability to conduct a comprehensive Rapid Improvement Event project based on past data to drive milestone improvements could not have been done without Kirk's observation, attention to detail, and overall desire to improve the patient experience for newly inducted midshipmen."

"Your participation and feedback helped us shape Naval Health Clinic Annapolis to enhance our patients' experience. Thank you so much for your hard work and keep pressing to improve our healthcare system. Bravo Zulu on a job well done," wrote McGinnis.

Kirk attests the idea originated with Modi, a pediatrician she worked with at Naval Health Clinic Annapolis.

"He wanted to streamline a new process for Induction Day at the Naval Academy for the beginning of plebe summer, which is basically 'boot camp' for Midshipmen," said Kirk. "What we did to improve the process was use data from previous years to discover where we could cut back and organize to save money on not only unnecessary vaccines, but hourly wages by cutting down time immensely."

Kirk explained the team sent out vaccination forms in the acceptance packet for the incoming students and parents to fill out and submit prior to their arrival on Induction Day.

"Immunizations staff screened each and every student to see which vaccines they still needed, if any," explained Kirk. "On Induction Day, they were given only what they needed, which met our goals of cutting down on time and wasting vaccines."

Of equal note was Kirk was also commended for contributing in publication of the article, "Using Lean Six Sigma Methodology to Improve a Mass Immunization Process at the United States Naval Academy," which appeared in Military Medicine-International Journal of Association of Military Surgeons of the U.S., Volume 181, June.

"It is an amazing honor to be recognized in this article not only as an active-duty member, but as an enlisted member," Kirk said. "To me, this symbolizes that no matter what your rank, great ideas can come from anyone. We owe a huge thanks to our leadership, Dr. Modi, for including us in the process and for recognizing us alongside himself as authors for this article."

Kirk assisted in the entire process from the initial stages through realization to where it ended up being published.

"My team and I spent long hours mapping out our goals and strategies and arranging our ideas, as well as screening immunization forms and transcribing into the students medical records," shared Kirk. "When it came time to put our well-thought-out process to the test, we took a few days to set up and get ready for show time. Everything ended up running smooth."

She added, along with Taylor, they were the leaders and subject matter experts responsible for oversight and safety and made sure everything ran according to plan.

Kirk attests having a Sailor with corpsman training was the perfect choice to help formulate and carry out such a project.

"Each and every day we are building relationships with patients, and are the first and last interaction when patients come for an appointment or walk-in visit," Kirk said. "Who better to have on your team of process analysis than the people that spend the most time and have the most impact with patients during their visit? Lean Six Sigma can be utilized in any workplace. I believe that having Sailors trained on how to apply LSS in their own work center is important, because technology and our environments are constantly evolving. For us to evolve with it, sometimes we have to cut down what may be holding us back by using process analysis and understanding waste. As we evolve we become more efficient."

For Kirk, there was fulfilment in being part of a team project which has made a positive impact in improving patient-centered care at such a notable military institute.

"It is truly amazing to see that all the hard work we put into this LSS project is now being used as a model for process improvement at the Naval Academy," stated Kirk. "Induction Day is the first impression those students have on not only the academy, but also Navy Medicine. The impact we left on them this day will determine the care they can expect to receive during their time at the academy, as well as in the Navy."

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