The National Council for Behavorial Healthcare

Business & Practice Areas: Performance Improvement



For more information on the National Council's performance initiatives and to learn how you can get involved, contact Chuck Ingoglia, Vice President, Public Policy.
 
  • Press Release: Increasing Access to Mental Health and Addictions Services in Tough Times
  • Mental Health Weekly report on the National Council's performance improvement initiatives

Access Redesign Quality Improvement Initiative

The National Council’s Access Redesign Quality Improvement Initiative is a state-wide initiative involving up to 50 community behavioral health organizations in two states (25 in each) chosen through a competitive application process. Organizations are provided with the tools to:
  • Make access to care more timely for your organization and across your state.
  • Address revenue losses due to no-show appointments.
  • Learn performance improvement technology that can be applied to other problem areas within your organization.

Participants in this project must meet a one dollar match for every nine dollars provided by the grant funds. Therefore, the total state match contribution requirement will be $10,000 per state ($20,000 collective match for both states) based on the total of $180,000 in grant funds currently available for this two-state initiative (amount of funds allocated to each state is based on number of CBHOs enrolled and other factors). Additionally, each state can increase the number of participating CBHOs from a total of up to twenty-five per state upon payment of $2,500 per additional CBHO that desires to participate. This payment is in addition to the state match indicated above.

Access and Engagement Quality Improvement Initiative

The National Council Access and Engagement Quality Improvement Initiative started in March 2009. Participating organizations will be provided with the tools necessary to:
  • Improve access to care.
  • Reduce the risks associated with non-adherence to treatment.
  • Address revenue losses due to no-show appointments.
  • Learn performance improvement technology that can be applied to other problem areas within your organization.
 
The National Council’s Access and Engagement Quality Improvement Initiative is a year-long learning collaborative involving ten community behavioral health organizations chosen through a competitive application process. 
 
The project is sponsored by Janssen and Ortho-McNeil Janssen Scientific Affairs and all project costs, including conference calls, travel, and consultation time, are free to participants. Additionally, the National Council will provide participating sites with $3,000 to cover incidental expenses.

 


Access and Retention Initiative

A year-long National Council Access and Retention Initiative that concluded in September 2008 resulted in dramatic increases in the numbers of consumers served by participating mental health and addictions treatment organizations after they implemented a series of process improvement measures. Participants reported that as a result of the Access and Retention Initiative they were able to achieve:
  • More than 20% increase in capacity for outpatient and medical services by better managing no shows and cancellations.
  • 22% improvement in completion of paperwork/documentation within 24 hours of service delivery.
  • Transformation of data into actionable information for change and improvement.
  • Nearly 40% increase in consumers receiving an appointment within 2 weeks of initial call.
  • Ability to serve increased number of clients with fewer staff.
Learn more and review outcomes in the Access and Retention Initiative summary report.

The National Council is pleased to share tools and case studies from the Access and Retention Initiative and encourages you to use these in your own organization:

 


 

Lean Six Sigma Initiative


Through a partnership with Eli Lilly and Company, the National Council is currently providing three member organizations access to the benefits of Six Sigma quality management strategies in order to assess their process of care, and to implement specific and measurable improvements in their system.  

Lean Six Sigma is the integration of two powerful business improvement approaches pioneered 2 decades ago by companies such as Motorola and GE.  It has more recently been adopted by companies in the health care industry to eliminate non-value added activities, reduce waste, and decrease the defect rate and variability within a process.  Lean Six Sigma has also been used to increase process speed and reliability, while at the same time improving overall performance in delivering value to patients.  Lean Six Sigma methodology, tools, and leadership will be employed by a certified full-time Black Belt (a Six Sigma specialist) who will guide the team to the most appropriate and logical solutions.  

Six Sigma Project Sites
LifeSpring is a mental health clinic in Jeffersonville, Indiana which provides services for over 8500 clients in 6 counties in southern Indiana. The goal of their Six Sigma project is to decrease patient no-show rate to less than 25% of initial visits and increase physician utilization up to a billable hour amount of 24 hours/week.   

Valley Cities in Auburn, WA provides counseling and consulting services in central Washington State to nearly 6000 clients and is struggling with access problems. The goal of their Six Sigma project is to decrease the intake time to less than 10 days, the time from intake to first appointment to less than 30 days, and the lag time between discharge and appointment to less than 7 days. 

Rushford Center Inc. in Meriden, CT,  provides a wide variety of services to nearly 6500 clients across three counties in central Connecticut.  The goal of the process mapping project is to identify a patient type (most likely, the highest risk type) and "follow" that patient through the process of call center, intake, treatment, and discharge. After this mapping, the identification of gaps or areas of weakness in the process can be done and further project work can be undertaken.


Client Retention and Engagement Benchmarking Project

The National Council in partnership with Behavioral Pathway Systems is soliciting participants for Phase II of a process benchmarking initiative focused on improving Client Retention/ Engagement.
 

Process benchmarking is a structured applied research technique that is employed to identify potential best practices. The procedure involves identifying top performing organizations and then examining the methods and strategies that distinguish those top performers from others.  The tactics that prove to distinguish between top performers and the rest may then be regarded as potential best practices.
 

Phase I Findings
More than 350 members participated in Phase I of the project, which shed important light on improving client engagement and helped distinguish top performing organizations. A web-based survey was established to examine the practices that might be associated with the effective engagement and retention of adults receiving outpatient behavioral health services. The methods that emerged as “best practices” in increasing capacity to serve clients were:
  • Limiting the initial intake process to an hour or less.
  • Having clinicians call clients that no-show or cancel two times in a row.
  • Making it a standard practice to personally introduce a client to a member of his or her treatment team during or immediately after the intake.
  •  Having clinicians routinely call clients before the initial face-to-face appointment to introduce themselves and establish a rapport.

To learn more, read the report on Phase I of the Client Retention and Engagement Benchmarking Project.

Phase II Survey
Organizations that wish to participate in Phase II are required to complete our 5-minute online survey by January 30. 
 
This online survey presents a list of the potential best practices that were identified in Phase I and asks follow up questions to identify those practices participants intend to implement or strengthen in the next year. Six months from now, we will ask participants to complete a similar brief online survey to report those strategies that their organization has actually implemented or strengthened. This project concludes with a final survey one year from now which solicits updated information about strategies adopted and an updated measure of client retention/engagement. 
 

For more information, contact Jeannie Campbell at 202-684-7457, ext. 226 or at JeannieC@thenationalcouncil.org


 

Continuity of Therapy Guidelines

One of the most critical periods in the recovery of the more than 2 million Americans with schizophrenia is the transition from intense inpatient care to community-based outpatient settings. When people fail to continue treatment and care after discharge from hospital, it results in increased emergency room use, repeated hospitalizations, family chaos, homelessness, incarceration, and even death. Hospitals and community-based organizations need uniform standards, education, and better coordination of treatment and services to ensure that patients with schizophrenia and other mental illness have access continued care after hospital discharge.

In December 2006, the National Council for Community Behavioral Healthcare assembled a panel of 24 experts from the mental health community to recommend new approaches to help ensure continuity of care. The panel was supported by Janssen, L.P. and included representatives from leading accrediting bodies and hospital and community treatment organizations, as well as patients, family members, researchers, state authorities, and psychiatric leaders. The panel's recommendations for continuity of medication therapy for the treatment of schizophrenia and other serious mental illnesses were released in March 2007.


Other National Council Resources for Performance Improvement

SPQM Dashboards

National Council Magazine, Improving Clinical Practice

National Council Magazine, Policy and Practice Update

 

BOOKS AND DVDs

Concurrent Documentation DVDs by David Lloyd

How to Deliver Accountable Care by David Lloyd

How to Deliver Accountable Care Workbook by Scott Lloyd

Using Data to Drive Your Service Delivery Strategies by Scott Lloyd

 
 
 

WEBINAR RECORDINGS/PRESENTATIONS

 
 
 
  • Strategies for Redesigning Your Access Process
    Scott Lloyd, Sept 4, 2008

Presentation

Intake Process Calculator

Cost Based Productivity Calculator

 
 
  • Evaluating Performance Management Within Your Organization
    Paul Lefkovitz, Jul 29, 2008

Recording

Presentation

Performance Management Inventory

  • Concurrent Documentation
    David Lloyd, September 10, 2007

Presentation 

 

  • Risk Management: Avoiding Lawsuits
    Ron Zimmet, February 28, 2008

Presentation

Recording
Enter Recording ID "HW48J3" and Recording Key "National Council Live"

 


Medicaid Mental Health

Real Stories

National Council member organizations across the country work hard to give nearly 6 million adults, children, and families with mental illnesses and addiction disorders a chance to recover and lead productive lives. Read their stories