Hospital - Behavioral Health
In six weeks the backlog (85 patients) was gone. Patients calling in were assigned to a worker and given an appointment within a week; this was down from the 5 weeks that were initially required.
Behavioral Health
Lean healthcare initiatives don't have to be overly complex. Sometime you just have to identify the problem, spend a little time identifying the solution and then implement the solution. Other times it's as simple (or as hard) as finding time to implement a known solution. This is one such case. A behavioral health department had a long lead time from when the patient first made contact until their first appointment.
After completing the value stream map, two waiting areas were noted. The first wait took place after the phone interview. The phone interview was a triage activity that fast tracked any patients that were thought to be at risk. The other patients were put on a list and then the list was reviewed at a weekly staff meeting where the patients were assigned to a worker.
The issue was that the triage employees prioritized their work by talking on the phone to patients being the most important and keeping the list up to date was a secondary activity.
By phone, the patients' information was taken down and when there was time, the list would be updated and entered into the computer. Over time, the patients waiting to get on the list for the staff assignment was growing. When the team took on the assignment to reduce the waiting list it had grown to 85 potential patients.
The team put together a Future State Implementation Plan that would bring the backlog down to zero and then another Plan to keep the wait time, to be assigned, to less than one week. Within six weeks of starting the Implementation, the team was successful in reducing the backlog - see the graph below. There were 10 interventions in order to be successful. Since then they have implemented a process that ensures all the patients that phone in are given a first appointment time within a week of calling.
Many times the employees in the value stream mapping process tell us 'they already know the problems' or when a problem is identified 'they say that they already knew about it'. In this case the employees knew there was an issue however they couldn't free up anytime to resolve the problem, so they did the best they could. The Enterprise Value Stream Mapping ™ process that they went through with Lean Healthcare Inc. helped management 'see' the issues and 'see' the Future State that could be. This understanding of the Future State, by all staff and management, was the motivation and knowledge they required, for them to become serious about solving the issue of 'wait times' and assign time for the employees to resolve the problems.
The results were quick and impressive. In six weeks the backlog (85 patients) was gone. Patients calling in were assigned to a worker and given an appointment within a week; this was down from the 5 weeks that were initially required.
Of course, the other benefits are the patient satisfaction and staff pride in their work. This team has changed their thinking and will always be searching for ways to provide even better service and assistance to their patients using Lean.
This first Future State transformation is not the final solution. The group is now excited by their success and the team is now working on their new goal of assigning an appointment for the patient at the time they call the triage area. The Lean process is one of continuous improvement and an ongoing desire to make all processes better.