Process improvement for behavioral health

Use All Time Slots Including Special Use Time Slots

Problem:

When time slots are set aside for special use they are often not used.

Solution:

Use all available time slots, especially appointments that have been set aside for special use.

Featured Stories

Sinnissippi Centers in Dixon, Illinois reduced the waiting time for assessments from 15 days to 5 days by scheduling assessments for the first available time slot that a counselor had available instead of setting aside set times for assessments.

Mid-Eastern Council on Chemical Abuse in Des Moines and Iowa City, Iowa reduced waiting time from 48 days to 22 days by scheduling the first available time slot for extended outpatient admission—in combination with other changes—regardless of the client’s payment source or referral source. Previously, they reserved slots for clients with insurance or private payment resources.

Lessons Learned

  • Offer clients the next available time slot. If the client doesn’t accept it, attempt to schedule the appointment at his/her preferred time. This is sometimes called “ondemand” scheduling.

Tracking Measures

Cycle Measure

Number of days until the next available assessment appointment and/or treatment session

Data Collection Form

Next Available Appointment Tracking Spreadsheet

ActionSteps

Plan

  • 1. Collect baseline data for the number of days until the next available assessment appointment and/or treatment session.

Do

  • 2. Ask two or three counselors to open access to all their time slots for two weeks after the baseline measure is taken.
  • 3. Re-check the number of days until the next available appointment.

Study

  • 4. Check the fidelity of the change. Was the change implemented as planned?
  • 5. Evaluate the change:
    • Did the number of days until the next available appointment decrease?
    • Were a greater number of clients offered the next available time slot?
    • Did the number of days until the next available appointment decrease?
    • Were a greater number of clients seen overall?

Act

  • 6. Adjust the number of counselors or the number of unrestricted time slots and re-test this promising practice for an additional two weeks.

Repeat this series of steps until you have provided open access to most of your counselors’ time slots.

More Stories

The Jackie Nitschke Center in Green Bay, Wisconsin reduced the waiting time for treatment from 8.2 days to 7.1 days by encouraging clients to take the next available appointment for an assessment.

Gateway to Prevention and Recovery in Shawnee, Oklahoma made unused time slots available and eliminated the practice of scheduling several repeat visits before admitting a client, which filled valuable time slots with clients who may not continue in treatment. Now, they make appointments no more than 5 working days from the first request for service, except rarely when there are special needs.

Prairie Ridge Addiction Treatment Services in Mason City, Iowa increased their capacity to schedule appointments by opening counselors’ schedules so that they could perform assessments whenever they were available. They also re-defined “crisis time” so that they could accommodate more requests for same-day assessments.

Specialized Outpatient Services in Oklahoma City, Oklahoma reduced the waiting time for assessments from 15 days to 4 days by opening unused assessment appointments that were formerly set aside for specific populations, along with other changes.