CASE STUDIES

Improving the Journey

of a Mental Health Client

Problem Statement:

Clients with significant concurrent disorders have complex needs, they receive services from the entire care continuum and are often challenging to serve.  They currently experience service gaps, long wait times to receive services & discontinuity of care at various points in the care path.  This may result in frequent avoidable ED re-admissions.

 

Objective:

To understand the true experience of a mental health client in order to align hospital and community providers on a shared vision of mental healthcare as a system of integrated care.

 

Approach Taken:

Value Stream Analysis & Coaching Support on multiple initiatives

 

Results:

  • Created a shared vision across hospital and community mental health providers

  • Identified and prioritized a list of 30 opportunities for improvement based on impact to Client Quality of Care, Avoidable ED Admissions, ED LOS, Repeat IP admissions, and Effort Involved. 

  • Created charters and identified teams for the top 5 Opportunities for improvement

  • Provided coaching support to each team for 1 year.  Support included guidance on project management, facilitation, data analysis, leveraging the lean sigma toolset, piloting (leveraging PDCA) and measuring/reporting on results. 

 

The following are the top 5 opportunities for improvement:

  • Predictive and Collaborative Discharge Planning

  • Moving from a Maintenance to a Recovery System

  • Peer Navigator Pilot in ED/ IP Unit

  • Standard Method for Handoffs/ Transitions/ Referrals

  • Standardized use of OCAN/ GAINS

Improving Flow Within the Oncology Clinic

Problem Statement:

The scheduling process around Oncology visits is complex. There is no standardized process and no overall visibility to the bigger picture.  This results in:

  • A potential negative experience from patients who may be waiting longer than anticipated and or having their appointment cancelled/re-scheduled. 

  • Uneven distribution of patients per Oncologist

  • Unnecessary frustration experienced by staff attempting to execute to an unpredictable schedule

 

Objective:

Create predictability within the Oncology Schedule.  Measured by: % Oncology patients who start on time (On time = <15 mins of scheduled start/ time)

Approach Taken:

Kaizen Event

A Kaizen event implementing the following concepts:

  • Level load the schedule

  • Standard work

  • Creating an awareness of clinic performance amongst the team (data driven clinic) through the use of daily Huddles and a Huddle Board

Results: Increase in % of Oncology patients seen on time; even distribution of patients/ Oncologist; Decrease in % of patients double booked

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