Online Program

Improving access and directing patients to the best fit for care (Residential Psychiatric Treatment)

Tuesday, November 5, 2013 : 8:50 a.m. - 9:10 a.m.

Lisa Horvitz, SM, Master of Science, Administration, McLean Hospital, Belmont, MA
The aim of the work has been to serve more patients in our residential programs, increase occupancy and direct patients to the best fit for care. Interventions have focused on the residential “front door.” The objectives include streamlining and standardizing operations, specifically the processes in place to handle inquiries while still creating a warm, informative, responsive, excellent, and lasting first impression that is consistent between programs. Some of the challenges we have successfully navigated include a decentralized system for residential admission, limited funding and staff, limited information systems resources, minimal residential infrastructure and matrix reporting structure. The interventions can roughly be characterized as behavioral, structural, and technical. We applied concepts from Lean such as defining value from the customer's perspective and eliminating waste. Working closely with directors and admissions coordinators, we identified areas for improvement in the inquiry process, built relationships, and made substantial changes to business practices and expectations. Over the past three years, we have spread this work from one site to another five then to an additional three. Here are six highlights of successful changes we have implemented: • Setting the expectation of full occupancy when safe and appropriate • Development of admission criteria to save time for the inquirer and improve equitability • Implementation of Uniform Inquiry Form improves efficiency by reducing the number of subsequent phone calls to gather information needed to make an admission decision. • Best fit for care: When programs are not the best fit for care, the expectation is to refer the patient. • Use data to guide management decisions: Programs now enter each inquiry into our custom-built online relational database, a sustainable solution for managing inquiries and understanding admission patterns. We've been able to de-bunk some long-standing anecdotes or folklore about what happens at the front door of the residences.

Learning Areas:

Administration, management, leadership
Conduct evaluation related to programs, research, and other areas of practice
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Define and analyze barriers to full occupancy. Identify levels of intervention targets.

Keyword(s): Access to Health Care, Mental Health Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have brough my background in quality improvement, health care delivery, and Lean to bear on my work to improve operations at a private psychiatric hospital. I've led the work on which I'll present for 4 years. The changes introduced have been structural, behavioral, and technical. I've recieved Partners in Excellence awards in each year of employment recognizing exemplary performance.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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