Using Lean to Rapidly and Sustainably Transform a Behavioral Health Crisis Program: Impact on Throughput and Safety

Joint Commission Journal on Quality and Patient Safety
Margaret E BalfourChris A Carson

Abstract

Lean has been increasingly applied in health care to reduce waste and improve quality, particularly in fast-paced and high-acuity clinical settings such as emergency departments. In addition, Lean's focus on engagement of frontline staff in problem solving can be a catalyst for organizational change. In this study, ConnectionsAZ demonstrates how they applied Lean principles to rapidly and sustainably transform clinical operations in a behavioral health crisis facility. A multidisciplinary team of management and frontline staff defined values-based outcome measures, mapped the current and ideal processes, and developed new processes to achieve the ideal. Phase I was implemented within three months of assuming management of the facility and involved a redesign of flow, space utilization, and clinical protocols. Phase II was implemented three months later and improved the provider staffing model. Organizational changes such as the development of shift leads and daily huddles were implemented to sustain change and create an environment supportive of future improvements. Post-Phase I, there were significant decreases (pre vs. post and one-year post) in median door-to-door dwell time (343 min vs. 118 and 99), calls to security for be...Continue Reading

Citations

Apr 19, 2018·Journal of Psychosocial Nursing and Mental Health Services·Bryson C Okeoma
Oct 3, 2019·BJPsych Bulletin·Lauren AlexanderLeonard Douglas
Sep 24, 2020·Journal of Psychiatric and Mental Health Nursing·Jennifer D WoodChristine Barber
Jul 19, 2019·The Western Journal of Emergency Medicine·Christopher PateyKris Aubrey-Bassler
Dec 19, 2020·International Journal of Environmental Research and Public Health·Mariano JiménezManuel Domínguez
Jul 3, 2021·Healthcare·Davenilcio Luiz SouzaAnnibal José Scavarda

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