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Dale Jarvis

Dale Jarvis and Associates

Be There When I Need You

February 18, 2014 | Community Impact | Comments
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open access scheduling - behavioral health centers of excellence
Consider the following scenario:

Jaimie is a seventeen-year-old patient at the South End Community Health Center. She started receiving care for an eating disorder and depression shortly after the clinic began a primary care-behavioral health integration pilot. And the integrated care team manages Jaime’s care. One morning, her mother calls the clinic saying she has noticed cutting marks on her daughter’s arms that have gone unnoticed because Jaimie had been wearing long sleeves. What should she do? The team discusses options during the morning huddle and decides this is beyond what they can handle; they need to step Jaimie’s care up to the specialty behavioral health clinic that South End partners with.

Now, consider two alternative doors that Jaimie, her mother, and her care manager might walk through:

Door #1:

Jaimie’s behavioral healthcare manager calls the partner behavioral health clinic and discovers the best they can do is get her scheduled for an intake appointment in one week, but there’s a four-week wait to see a therapist and a six- to eight-week wait to see a psychiatrist. If this isn’t good enough, Jaimie and her mother should go to the local emergency room.

Door #2:

Jaimie’s behavioral healthcare manager calls the partner behavioral health clinic and is told they can see Jaimie right away and begin to wrap a care team around her to assess and begin treatment at that first visit, working with the primary care to co-manage the case.

Yes, I know I’m being as subtle as a carpenter installing kitchen cabinets with a sledge hammer, but you probably get my point. More importantly, which scenario is closest to what would happen if your organization got the call?

Element 3: Easy Access

“Be there when I need you.”Oregon Patient-Center Primary Care Home Program principles

A behavioral health center of excellence is known for ensuring that new and regular clients can get the right care, at the right time, in the right setting, by the right provider. Work processes have been reengineered to support same day/next day appointments and open access scheduling. The organization effectively manages no shows and cancellations, eliminates redundant information collection, and reduces the time between first appointment and completed treatment. One example of success is healthcare providers’ ability to get their clients into specialty behavioral healthcare with same day/next day access for high risk, high need clients.

Today’s questions…

Tell us what you think.

  • Am I right in assuming that Door #1 is not an option in the new healthcare ecosystem?
  • Is Door #2 an unrealistic, in-my-dreams fantasy that’s impossible in the current behavioral health funding environment?
  • If you think Door #2 is unrealistic, is it still essential to find a way to innovate your way to creating same day next day access for people like Jaimie? How would you do that?
  • How would you edit to the above description?

If you haven’t seen the behavioral health center of excellence draft concept paper, download it here. If you haven’t already, download the behavioral health center of excellence study guide.


Ask your colleagues to bring their thoughts to this crowdsourcing project. Share posts and your view with them on Twitter using the hashtag #WhatIsExcellence and share this on Facebook (or just email them and ask them to visit the blog).


Read all this projects blogs here.