In the past, outpatients in Mental Health were placed on a wait list for treatment for up to week without a known appointment date and at times could wait more than 30 days before meeting with a clinician. A client coming for mental health help could face many challenges in the time between reaching out and actually receiving care.
“The team decided that this was unacceptable and began to focus on reducing the waiting list by streamlining and standardizing assessment, appointment scheduling and documentation processes”, said Director of Mental Health and Addiction Services, Gary Shepherd. There was no standard process to determine who the client would be seen by or when.
“We were concerned about the wait lists and lack of a single point of entry. There was no standard process for clients to access our services.”
Gary Shepherd, Director of Mental Health and Addiction Services
Through a Rapid Process Improvement Workshop (RPIW), a team of front-line staff and client representatives created a shared appointment calendar. Once implemented, the calendar ensured that the client is offered a subsequent appointment during the initial contact with an intake worker. This eliminates the need for clients to wait for a call to be scheduled for follow-up appointments.
This is significant, as patient advisor Andrew Piasta stated, “You don’t know how good it is for clients to know they have their next appointment booked at the time of their current appointment.”
“You don’t know how good it is for clients to know they have their next appointment booked at the time of their current appointment.”
Andrew Piasta, patient advisor
As well, the team worked with the client documentation process to reduce the backlog of client documentation/dictation awaiting transcription. Consequently, faster transcription ensures that information in client medical records is readily available for on-going care.
The Mental Health Team’s efforts, which included the applying of lean methodologies and an RPIW, resulted in reduction of the patient treatment appointment wait list from 100 clients to 0 within the available resources. “Lean provided a formal structure to examine problems hand-in-hand with the clients who access our services and the staff who deliver the services,” said Shepherd, “The work of the team resulted in immediate improvements in access.”
Our patient representative, Andrew Piasta, had the following to say about the RPIW process:
“[I] saw the impact and effectiveness of the RPIW this week in how quickly the processes were adapted, accepted and implemented. This RPIW allowed me as patient representative to have an input and contribution and to be able to contribute ideas that have been, or will be acted upon. So often, workshops focus impact and effort on aspects of, and concerning, administration, personnel and workflow in the institution. This is self evident but it was I as a client upon whom the greatest impact was made.
I benefit when the system can, with expediency, book appointments for me, it is I who benefit when the contents of my patient file are up to date when the clinician needs them, I benefit when the Crises Assessment Team get together and make decisions to improve my treatment, I even benefit when the resource library is in order because my clinician can draw resource materials for me very quickly and he or she is not spending time doing administrative things and instead can focus on spending time with me and on my needs. So all of the things that happened this week benefit this institution, but they benefit me as a client the most, and for that I am grateful to the team and for the privilege to be a part of it.”
“I benefit when the system can, with expediency, book appointments for me, it is I who benefit when the contents of my patient file are up to date when the clinician needs them, I benefit when the Crises Assessment Team get together and make decisions to improve my treatment…”
Through the ongoing work with Lean in Mental Health and Addictions Services, clients are able to begin receiving treatment sooner, leading to reductions in client risk, less exacerbation of symptoms, and improved quality of life. Saskatchewan is using Lean methods to build a patient and family centred health care system for the province.