Process improvement for behavioral health

Assign Each Referrer a Single Contact Person


Too few referrals are made, and when they are, too few end in an admission.


Assign one contact person to each referral source to ensure that the needs of the referral source are being met.

Featured Stories

Boston Public Health Commission in Mattapan, Massachusetts increased admissions by 49 percent to 8.4 admissions per month by training staff on outreach strategies and assigning them to specific agencies to do outpatient outreach.

SSTAR in Fall River, Massachusetts increased the daily census on its Dual Diagnosis Services Unit from 13.86 to 15.86 by streamlining the process for admission for five priority hospitals that were making appropriate referrals and giving them access to a telephone “hotline” that the admissions clerk answered on a portable phone which she kept accessible at all times.

Lessons Learned

  • Acknowledge all referrals. Referrers need to be reminded about your services. One way is to send a thank you note.
  • Keep them informed about “their” client to the extent that confidentiality is not broken.
  • Visit referrers periodically and ask, “What’s it like to refer a client to us?”

Tracking Measures

Cycle Measure

Percentage of referred clients who were admitted

Data Collection Forms



  • 1. Select one referral source.
  • 2. Select one person to be the primary contact for this referral source.
  • 3. Collect baseline data for two weeks to track the percentage of referred clients who are admitted.


  • 4. Make contact with the referrer and let them know how to reach you.
  • 5. Find out more about the needs of the referral source so that you can help meet these needs.
  • 6. Test this change for the next two weeks.
  • 7. Track the percentage of clients referred by the selected referral source who are admitted.


  • 8. Check the fidelity of the change. Was the change implemented as planned?
  • 9. Evaluate the change:
    • How did the referral source respond to having a single contact person?
    • Was the selected contact person a good match for the referral source?
    • Did the percentage of referred clients who were admitted increase?
    • Did the number of referrals from the selected referrer increase?


  • 10. If this change was an improvement:
    • Adopt this change or adapt it for more improvement and re-test it with the same referral source.
    • Expand the use of this process to other referral sources.
    • Document the processes that resulted in an improvement so that you can continue to use them efficiently.
    • Test other, related promising practices that apply to your setting.

If this change was not an improvement and you can’t make it work, abandon this practice and test other promising practices that might be more successful in your setting.

More Stories

Connecticut Renaissance in Norwalk, Connecticut increased outpatient admissions by 83.3 percent by providing their top three referral sources with information about a special walk-in admissions process. The program director made personal communications to connect with their major referral sources.

Vanguard Services in Arlington, Virginia increased monthly outpatient admissions by 112 percent by establishing relationships with various referral sources, such as Employee Assistance Professionals, and conducting site visits.