Presented "Integrating Lean into Behavioral Healthcare Settings to Increase Access to Care" at Shippensburg University’s Social Inclusion and Social J
Dr. Jason Raines
Business Consultant | Board Member | Adjunct Instructor |Lean Sensei | Operational Excellence Manager at HNL Lab Medicine
Abstract:
People with mental health and substance abuse needs are often excluded and marginalized. Large numbers of people with mental health needs often receive limited help or are incarcerated. Currently, people with mental health conditions or substance abuse issues wanting help must wait for treatment. Shortage of professionals providing treatment, a large amount of waste in the system and the high cost of care, aids in the exclusion or delay of treatment. The Lean continues improvement methodology can improve any person's access to treatment. Lean enables a professional to successfully treat more people each day while lowering the cost of treatment. The Lean continues improvement methodology can be implemented in any behavioral health care setting to improve access and outcomes. Both items would help a person be more social included in society and be view as a fully functional active member.
Outline of slide deck:
? Disclosure Statement
? The author is a member of the Raines Consulting Group, LLC.
? The author has no conflicts of interests to disclose.
? Defining What We Are Discussing
? Lean
? Lean in its simplest form is a system which removes waste or non-value add from a process.
? Behavioral Healthcare
? Behavioral healthcare encompasses mental illnesses, substance misuse and abuse, suicidality, and serious psychologic distress.
? Key Significant Point
? Despite their best efforts, too many behavioral health treatment programs fail to deliver the desired outcomes or time needed to meet with clients.
? Impact
? Behavioral health problems are among the most common and disabling health conditions worldwide.
? The CDC estimates that 46% of U.S. adults will experience a mental health disorder.
? Impact
? In 2011, 605,208 children visited an emergency department (ED) for a mental health-related issue.
? There has been a great increase in the use of psychotropic medications in children and adolescents.
? Unintended consequences of pay for performance(P4P)
? The Three Views of Lean
? Value all services and items the customer is willing to pay for if they knew about it.
? Business non-value add, all services and items the customer is unwilling to pay for, must be done for the organization to operate.
? Non-value add, all services and items the customer is unwilling to pay for or anything that does not change the service.
? Lean’s Impact
? Reduces door to provider time.
? Increases the number of people who can have an appointment.
? Reduces cost of treatment.
? Questions
? References
? Arthur, J. (2011). Lean six sigma for hospitals: Simple steps to fast, affordable, and flawless healthcare. New York: McGraw-Hill.
? Bachman, J. (2006). Pay for Performance in Primary and Specialty Behavioral Health Care: Two "Concept" Proposals. Professional Psychology: Research & Practice, 37, 4.
? Clancy, G., & Graban, M. ( 2014). Engaging Staff as Problem Solvers Leads to Continuous Improvement at Allina Health. Global Business and Organizational Excellence, 33, 6, 35-42.
? Chalice, R., (2007). Improving healthcare using Toyota lean production methods: 46 steps for improvement (2nd ed.). Milwaukee, WI: ASQ Press.
? Critchley, S. (2015). Improving Medication Administration Safety in a Community Hospital Setting Using Lean Methodology. Journal of Nursing Care Quality, 1.
? Dean, M. (2013). Lean healthcare deployment and sustainability. New York, NY; McGraw Hill.
? Lay, D. (2013). Lean HR: Introducing process excellence to your practice. Lexington, KY
? Liker, J. K., & Franz, J. K. (2011). The Toyota way to continuous improvement: Linking strategy and operational excellence to achieve superior performance. New York. NY: McGraw-Hill.
? Hartman, B. (2015). The lean farm: How to minimize waste, increase efficiency, and maximize value and profits with less work. White River Junction, VT: Chelsea Green Publishing.
? Hoerl, R. W., & Snee, R. D. (2009). Post-financial meltdown: What do the services industries need from us now?. Applied Stochastic Models in Business and Industry, 25, 5, 509-521
? Johnson, P. M., Patterson, C. J., & O Connell, M. P. (2013). Lean methodology. The Nurse Practitioner, 38, 12, 1-7.
? Glassman, D. M., & Spahn, K. (2012). Performance Measurement for Nonprofits. Journal of Applied Corporate Finance, 24, 2, 72-77
? Graban, M. (2012). Lean : Improving quality, patient safety, and employee engagement, second edition. Boca Raton, Fla: CRC Press.
? Merlino, J. P., Omi, J., & Bowen, J. (2014). Lean behavioral health: The Kings County Hospital story. New York, NY: Oxford Press.
? Oppenheim, B. W., & Felbur, M. J. (2015). Lean for banks: Improving quality, productivity, and morale in financial offices
? Raines, J. (2015). Gemba, Cookies RIE: Lean Tools To Save Time And Money. Healing Magazine vol. 20, No. 1, pages 30-31.
? Raines, J. (2014). LEAN: The Means For Creating Extra Time And Money In Healthcare. Healing Magazine vol. 19, No. 2, pages 30-31.
? Robinson, M. E. (2016). Behavioral health. Nursing, 46, 9, 61-65.
? Rosenau, P. V., & Linder, S. H. (2003). Two Decades of Research Comparing For-Profit and Nonprofit Health Provider Performance in the United States. Social Science Quarterly, 84, 2, 219-241.
? Steinfeld, B., Scott, J., Vilander, G., Marx, L., Quirk, M., Lindberg, J., & Koerner, K. (2015). The Role of Lean Process Improvement in Implementation of Evidence-Based Practices in Behavioral Health Care. The Journal of Behavioral Health Services & Research, 42, 4, 504-18.
? Steinhausen, H.-C. (2015). Recent international trends in psychotropic medication prescriptions for children and adolescents. European Child & Adolescent Psychiatry, 24, 6, 635-640.
? Torio, C. M., Encinosa, W., Berdahl, T., McCormick, M. C., & Simpson, L. A. ( 2015). Annual Report on Health Care for Children and Youth in the United States: National Estimates of Cost, Utilization, and Expenditures for Children With Mental Health Conditions. Academic Pediatrics, 15, 1, 19-35.
? Wang, F.-K., & Chen, K.-S. (2010). Applying Lean Six Sigma and TRIZ methodology in banking services. Total Quality Management & Business Excellence, 21, 3, 301-315
? Watkins, E. Y., Kemeter, D. M., Spiess, A., Corrigan, E., Kateley , Wills, J. V., Mancha, B. E., & Bell, A. M. (2014). Performance excellence: using Lean Six Sigma tools to improve the US Army behavioral health surveillance process, boost team morale, and maximize value to customers and stakeholders. U.s. Army Medical Department Journal, 91-5.
? Woolderink, M., Lynch, F. L., Van, A. D., Beecham, J., Evers, S. M., Paulus, A. T., & Van, S.C. P. (2015). Methodological considerations in service use assessment for children and youth with mental health Conditions; issues for economic evaluation. Administration and Policy in Mental Health, 42, 3, 296-308.
? Unützer, J., Chan, Y.-F., Hafer, E., Knaster, J., Shields, A., Powers, D., & Veith, R. C. (2012). Quality Improvement With Pay-for-Performance Incentives in Integrated Behavioral Health Care. American Journal of Public Health, 102, 6.