Hutchings Psychiatric CenterMadison Street Clinic

Change Team Results

Hutchings Psychiatric CenterAdult Outpatient services

• Admission criteria: Serves Onondaga Co. residents who have an Axis I diagnosis, and a severe, persistent mental illness.

• Current Census: 1,150 at two outpatient clinics.

• Treatment team model: A Psychiatrist/NP and a therapist are assigned to each case.

Services Provided

• 1:1 therapy, Psychiatric evaluation, medication management, family psycho-education, crisis intervention, group therapy, and vocational/ rehabilitation services.

• Medication Room services include: monitoring client’s height, weight, BP and smoking status; providing medication education, and giving IM medications.

PDSA – What did you do and why?

• Plan: Coordination of Medication orders and Prescriptions

• Step #1: Educated clients and residential programs about new medication room policies & procedures.

• Step #2: Worked to re-schedule MD/NP no-shows. -Secretary sent the team a daily no-show list -Therapist re-scheduled the appointments• Why?: Improves service delivery and assists clients with

independently managing their treatment. Increases staff productivity and services provided.

Decision Support – What Happened and How Do You Know?• Calls to the

medication room decreased from 10 per day in March ’09 to 2 per day in June ’09.

0

3

6

9

12

March '09 June '09

Number of Calls

Decision Support – What Happened and How Do You Know?• One Prescriber had a

5% increase in Productivity and an increase in service hours, from 34 to 46, between March ’09 and June ’09.

• Service Hours

34

4044 46

0

20

40

60

March April May June

2009

Services Hours

Business Case and/or Strategic Advantage for the Organization

• Improved coordination of clinic services. • Improved organization of the medication room

allowing nurses more time for cardiometabolic monitoring.

• Clients more likely to stay involved in treatment if no-shows are re-scheduled.

• Increased staff productivity• Allows Prescribers more time to see clients.

The Plan for Sustainability• Secretaries will continue to send out a daily list of

patients who “no-show” for MD/NP appointments.• Therapists will coordinate re-scheduling of no-show

appointments.• All new clients will be given information about the

medication room policies and procedures• All existing clients will be reminded about medication

room policies and procedures (signs and verbally).• Residential programs will receive reminders re:

medication room policies and procedures.

New Change Team Project• Goal: Increase # of groups offered and improve

coordination and planning of group programs. • Next steps: -Arrange for a 2nd group therapy room in the clinic -Survey consumers re: group interest -Survey staff re: group interest/experience -Develop Group planning/coordination team -Improve marketing efforts for groups -Get baseline data re: # consumers in groups -Arrange group therapy training for interested staff