Chicago Women’s Health Center

Restructuring a clinical program after staffing changes

CWHC Service Design Project

Role: Sole Service Designer

Tools used: Figma, Google Workspace

Timeline: September 2022-February 2023

Chicago Women’s Health Center is an independent feminist health center with a 47 year history of providing accessible, compassionate and affirming care to women and trans people. I joined CWHC as a Service Designer to restructure the Clinical Services Program. After a major shift in staffing, many of the structures that upheld CWHC’s model of care were no longer in place.  My focus has been to plan and organize the program’s structure, from roles and responsibilities to processes and systems, to improve the staff’s experience, so they can continue to provide the compassionate affirming human centered care that the organization is known for.

Overview:

Why were staff leaving? What were the challenges making staying at CWHC untenable?

Through research that included group discussions and review of exit interviews, I was able to identify four main challenges.

The main reasons staff felt unable to continue the program as is included:

  • Not enough staff to do the work needed to provide the care CWHC is known for, and that the staff truly wanted to provide

  • A licensed provider was needed to be on site to hold clinic.  CWHC was struggling with hiring and retaining licensed providers in part due to offering a below market salary.

  • More funding is needed to pay all staff a thriving wage.   As a non profit, CWHC relies heavily on funders and donations to operate.

  • CWHC relied on an apprentice style training system.  With the loss of experienced providers that training system could not safely support new providers.


Process at Glance

  • Facilitated workshops with staff to identify challenges and possible solutions

    • Identified four main pain points that would be addressed in the restructuring process

  • Led staff workshops to map current services

    • Identified gaps in workflows and areas of weakness 

    • Provided three immediate solutions to gaps identified through the mapping  workshop

  • Interviewed clinical staff to capture roles and responsibilities- the high priority tasks, tasks on hold, tasks that are not part of their job description and observed workflows of each staff member

    • Identified responsibilities that needed coverage and responsibilities that could be shifted

    • Identified key roles that needed to be filled and shifted responsibilities and focus of other roles to help increase funding

  • Created a service blueprint that maps out activities needed to ensure clients get the care they need and staff feel supported in providing that care. (See below)

Results:

  • Established a Volunteer Provider Program: Three medical students volunteers were trained to help with client follow up, two volunteer doctors joined to help supervise clinic, two volunteer providers joined the team to see their own clients

  • Created and filled a new Clinical Operations Director position to manage clinic flow and systems to address some safety concerns

  • That new clinic role allowed for a shift in responsibilities to allow for Clinical Services Director to explore more fundraising and building partnerships with an estimated impact of 20% increase in fundraising

  • With the new structure in place, staff reports more confidence in the stability of the program and some staff have returned 

  • The Clinical Services Program is able to re-open to new clients because of the added support from volunteer providers, both in providing care and client follow up

Next Steps:

Continue to hire for three program coordinator roles to help balance out the workload

The clinical and adminstrative team will re-evaluate the staffing structure in 6 months to see what adjustments should be made