Role 1 Strategic Nursing Team Role 2 Billing/Fiscal Role 3 Contractors Info/ Deliverables/ Job Aids/ Templates Systems Work content Time Elapsed Time START: Document vaccination on form © Continual Impact LLC 7/15/15 NextGen SNT Data Entry Process (Current State) Vaccination Forms Prep forms for next day Turn forms into manager Forms checked for errors & counted Count & Prep forms for next day Get forms from SNT manager Collect & Count Forms Page 1 End IMPACT SIIS? NextGen Total time Time Sub Step: 1 SNT Nurses Sub Step: 2 Prep Waste / Defect WT= 30min ET = 1-2 days WT= 1 Hour ET = 1-2 days WT = 10 minutes ET = 3 days Demograph ics Trained (jointly performed) Contractor logistics (jointly performed) Contractor Enters Demograp hics or Vaccines Count & Prep forms for next day Orient Contractors - Logistics (jointly performed) Sub Step: 3 TrainingSub Step: 4 Entering Administrati on Trained (jointly performed) Contractor Enters Demograp hics or Vaccines Prep for & Train Contractors (jointly performed) NextGen Insurance Eligibility Website/ NextGen Verify & Separate forms by insurance company Nurse Name stamps document Forms checked for errors & counted Time Vaccination Forms Training List Vaccination Forms Wait Time =

Role 1 School Nurse (*=CCS or SNT) Role 2 Strategic Nursing Team Manager Role 3 SNT Team Lead Role 4 SNT Nurses (includes lead) Work content Time Elapsed Time START: School Dates Selected * © Continual Impact LLC 7/15/15 NextGen Sub Step 1 School Nurse & SNT Process (Current State) Page 1 Total time Time Sub Step: 1 Preparation Sub Step: 2 On Site Wait Time = Some school nurses check forms for completeness Preliminary Count Shared w/ CPH Week Before..# Doses Shared w/ CPH Vaccinate (see next page) Schedules nurses for clinic – assigns lead Check forms for completeness Arrive at school Gets supplies for clinic Complete Form Attempts Pull kids from class in batches approx.10 Complete Y/N Resolved Y/N Do not vaccinate Determines clinic flow Screen Form Complete Y/N Complete Form Attempts Resolved Y/N Do not vaccinate Confirm Identity of child No Yes No WT= _____ ET = _______ WT= _____ ET = _______

Role 1 School Nurse (*=CCS or SNT) Role 2 Strategic Nursing Team Manager Role 3 SNT Team Lead Role 4 SNT Nurses (includes lead) Work content Time Elapsed Time © Continual Impact LLC 7/15/15 NextGen Sub Step 1 School Nurse & SNT Process (Current State) Collect forms from team Forms checked for errors & counted Page 1 Total time Time Sub Step: 2 On Site (Continued) Sub Step: 3 CPH Nurse Name stamps document Time Wait Time = Document vaccination on form Vaccinate (previous) Submit to billing Put in Pile – move to next child Send child back to class More clients Y/N Close clinic & return to CPH Collect Forms Copy forms & keep copy Get next batch (repeat process) More clients Y/N Forms checked for errors & completed Errors? Y/N Errors fixed Forms checked for errors & counted Errors? Y/N Yes No Yes No Yes No Yes No Collect forms from team leads WT= _____ ET = _______ WT= _____ ET = _______

Role 1 Strategic Nursing Team Manager Role 2 Billing Role 3 Contractors Role 4 Work content Time Elapsed Time © Continual Impact LLC 7/15/15 NextGen Sub Step 2: Prep Through Step 4: Entering Process (Current State) Page 1 Total time Time Sub Step: 1 Prepare Forms Time Wait Time = Submit to billing (previous pg.) Submit to billing department Prep forms for entry Count & Prep forms for next day Get forms from SNT manager Collect & Count Forms End Demographics Trained (jointly performed) Contractor logistics (jointly performed) Contractor Enters Demographics or Vaccines Orient Contractors - Logistics (jointly performed) Administration Trained (jointly performed) Prep for & Train Contractors (jointly performed) Verify & Separate forms by insurance company Contracto r Return **? Y/N Yes No Sub Step: 2 Training Contracto r Return **? Y/N Yes No Sub Step: 3 Entering ** = This step may occur at any time during rest of process. More Forms? Y/N Yes No Daily Return Completed Forms WT= _____ ET = _______ WT= _____ ET = _______ WT= _____ ET = _______