MOJ
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Commentary Volume 5 Issue 5
Process improvements in the behavioural healthcare setting
Keith Klostermann,1
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Susan Steffan2
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1Marriage and Family Therapy Program, USA
2Business Management and Leadership Department, New York
Correspondence: Keith Klostermann, Medaille College, 18 Agassiz Circle, Buffalo, NY 14214, USA, Tel 716-932-2559
Received: May 31, 2018 | Published: September 19, 2018
Citation: Klostermann K, Steffan S. Process improvements in the behavioural healthcare setting. MOJ Addict Med Ther. 2018;5(5):223-223. DOI: 10.15406/mojamt.2018.05.00124
Commentary
Given the limited and decreasing agency resources, many clinicians feel unsupported in trying to accomplish their daily tasks, with little to no recognition or validation from supervisors for their efforts. Burnout among clinicians and office staff is a reality. Although outside funding (private, public) may provide a source of relief, identifying appropriate funding streams can be time-consuming, competitive, and not always fruitful. Thus, the challenge for community providers is to adopt strategies of resource optimization. Effective implementation of process improvement, which allows the efficient use of scarce resources, can decrease patient wait times, improve staff efficiency, and save money. The purpose of this commentary is to provide performance improvement recommendations for mental health service providers and agencies.
Process Improvements in the behavioural healthcare setting
Most community mental health and substance abuse treatment providers share a common problem: shortage of resources. So many things to accomplish, overstretched staffs, and not enough time in the workday. Moreover, given the dearth of resources, many clinicians are left feeling unsupported in trying to accomplish their daily tasks, with little to no recognition or validation for their efforts. Burnout among clinicians and office staff is a reality. Although outside funding (private, public) may provide a source of relief, looking for grants and increased reimbursements can be time-consuming, competitive, and not always fruitful. Thus, the challenge for community providers is to adopt strategies of resource optimization. Effective implementation of process improvement, which allows the efficient use of scarce resources, can decrease patient wait times, improve staff efficiency, and save money.
The first step in any process improvement effort is to understand the processes as they currently exist. Start by creating a flow chart of the current process. As an example, if you wish to improve the new patient intake process, you would map all the steps involved. For instance, the following steps may be involved in the new patient intake process: 1) initial contact by the patient via phone or email, 2) completion of required forms and paperwork, 3) processing of those forms by office staff, 4) staff calls to insurance companies to confirm benefits, 5) identification of available appointment slots/scheduling, 6) reminder cards or calls, 7) wait time in the waiting room, and 10) initial consultation. Documenting the process should include all of the personnel involved, the time each action takes, and any wait times. A document may take five minutes to process, but might wait several hours before being processed. It is important to record all of those steps and associated times. Once you have a clear and detailed picture of the current workflow, you can identify the bottleneck in the process. A bottleneck is defined as the slowest step in the process and limits the output of the whole system. Once you have identified the bottleneck, you know what and where to focus your change efforts on.
After figuring out what to change, you have to determine what is causing the bottleneck. Talking to everyone involved (e.g., front desk staff, clinicians, billing staff) can help you find unnecessary steps, redundant forms, training needs, layout issues, etc. The people closest to the problem generally know what creates delays for them. Can resources be transferred to this bottleneck and increase its capacity? Can work be reallocated? Are there inefficiencies in the system? Focusing on this part of your flow-chart and creating attention to it, can help you make thoughtful improvements and better utilize scarce resources. Sometimes automating a process is the answer, or eliminating superfluous steps, or even retraining employees. While the specifics of this process depend on the needs of each individual practice, the leadership challenge is to ask the right questions.
Once potential changes are identified and implemented, their impact on the overall system must be measured. Did the changes achieve the results necessary? Can more be done? Have you improved the patient experience? If the changes have gone well, the temptation may be to congratulate yourself and consider your job done. However, with process improvement, you are never done. Once one bottleneck is resolved, by definition something else becomes the bottleneck–the slowest process in the system. The improvement process starts all over again. This is why process improvement becomes a culture change, led by a leadership team that is always seeking to improve the outcome for patients and staff alike.
Acknowledgements
None.
Conflict of interest
Author declares there is no conflict of interest.
©2018 Klostermann, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.