Access and Retention Initiative

• 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.

• Executive walkthrough protocol and data collection instrument
  In order to gain insights into obstacles to client access and retention and potential solutions, organizations are encouraged to engage in an executive level “Access and Retention Walkthrough” and collect data on  internal processes.
• Client engagement improvement strategies
  Suggested strategies to engage clients who missed 30% or more of their scheduled individual therapy appointments and/or medication management follow-up appointments.

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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

In September 2008, the National Council conducted a process benchmarking exercise in partnership with Behavioral Pathway Systems. The purpose of the project is to identify organizational strategies and practices that are associated with effective 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. 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:

• Having clinicians call clients that no-show or cancel two times in a row
• Limiting the initial intake process to an hour or less, on average
• 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 rapport
• Avoiding the use of voicemail at least 95% of the time when persons make their initial call to request outpatient services

Coming soon — the full report on the benchmarking initiative with best practices for client retention and engagement.

And don't miss our November 18 National Council Live webinar, where Paul Lefkovitz of Behavioral Pathway Systems will share and discuss these best practices.

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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.

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Other National Council Resources for Performance Improvement

SPQM Dashboards

National Council Magazine, Improving Clinical Practice

National Council Magazine, Policy and Practice Update

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BOOKS

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

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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"