Issue: Identify the systemic barriers and challenges faced by women in underserved communities that prevent them from accessing mental health services, and other essential supportive services.
Objective: To empower women in underserved communities by providing them with the resources, skills, and support needed to achieve economic independence, leadership roles, and social equality.
- Lack of Support Networks: Women lack supportive networks and mentorship opportunities to navigate challenges and pursue their goals effectively.
- Cultural Barriers: Deep-rooted cultural norms and traditions restrict women's opportunities and limit their ability to reach their full potential.
Strategy: Created a campaign and then utilized community workshops, radio programs, and social media platforms to educate women about mental health services offered at no cost and other resources such as skill-building workshops that included: training sessions on financial literacy, entrepreneurship, and leadership to equip women with practical skills.
Results:
- Increased Awareness: Ready campaigns have led to increased awareness among women about their rights and available resources.
- Economic Empowerment: Women have been able to improve their economic well-being through skill-building workshops.
- Community Leadership: Women have emerged as leaders within their communities, advocating for change and inspiring others.
Issue: Echelon Society’s Metal Health Clinic in need of a Board Member Development
Objective: Create a Board that aligns with the broader mission of promoting mental health through services of prevention, early identification, and intervention, including integrated services, and recovery as the goal. This includes:
- Governance: Ensuring the clinic operates with integrity and in compliance with laws and regulations.
- Financial Oversight: Overseeing the financial health, including budgeting, funding, and financial reporting.
- Strategic Planning: Guiding the clinic’s long-term strategy, including setting goals and evaluating progress.
- Community Engagement: Promoting the clinic within the community to gain support and raise awareness of mental health issues.
- Quality and Performance Monitoring: Ensuing the clinic provides high quality care and meets performance standards.
Strategy: To develop a robust Board for a mental health clinic and to achieve this, several approaches were essential. First it was crucial to clearly define the purpose and objectives of the board, ensuring alignment with the mental health clinic’s mission and vision. Secondly, identified the desired skills and expertise required on the board, covering areas such as finance, law, business, community engagement, and governance. Recruiting a diverse group of individuals from different backgrounds and professions to enrich discussions and decision-making processes. Additionally, establishing clear expectations regarding board member responsibilities, ensuring legal and ethical compliance, providing orientation and training, fostering collaboration and communication, and promoting accountability are essential steps in building an effective board. These strategies collectively contributed to the board's success in fulfilling its responsibilities.
Results: Developed a strong and effective board for Echelon Society Mental Health Clinic. Achieving the purpose and objective of the board aligned with the clinic's mission and vision. Identifying the necessary skills and expertise ensured that the board was well-equipped to address the diverse needs of the clinic. Additionally, established clear expectations for board members, ensuring legal and ethical compliance, provided orientation and training, fostered collaboration and communication, and promoted accountability. All of this contributed to a well-functioning board that can effectively support the clinic's mission and vision. Overall, these strategies collectively enhanced the board's ability to fulfill its responsibilities and positively impact the mental health clinic's operations and outcomes.
Case Study # 2
Improving Patient Experience and Clinic Efficiency at NYC Health and Hospitals Gotham Health Clinic
Background: In March 2016, NYC Health and Hospitals launched the Ambulatory Transition Project. The Gotham Health Clinic Morrisania Health Center's Adult Primary Care Unit was selected to spearhead this initiative. The project was overseen by the Director of Operations at the time.
Challenge: The primary challenge was to enhance the patient’s experience by reducing wait times and improving overall clinic efficiency. Specifically, the goal was to provide patients with a comprehensive medical visit lasting under 60 minutes, from registration to exit.
Objectives:
- Reduce the median patient visit cycle time.
- Increase patient and staff satisfaction.
- Improve the clinic's capacity to see more patients.
- Maintain or enhance the quality of care provided.
Solution:
- Strategy 1: Streamlined registration process
- Implemented self-service kiosks for patient check-in
- Digitized paperwork to reduce manual data entry
- Created a fast-track lane for patients with complete pre-visit information
- Strategy 2: Implemented a new patient flow system
- Introduced a color-coded system to track patient progress through the visit
- Utilized electronic dashboards to display real-time patient status
- Designated staff members as flow coordinators to manage patient movement
- Strategy 3: Optimized scheduling practices
- Adopted a modified wave scheduling approach to reduce wait times
- Implemented reminders via text and phone to decrease no-shows
- Created dedicated slots for same-day appointments and follow-ups
- Strategy 4: Enhanced staff training and communication
- Conducted workshops on efficient communication and handoffs
- Trained staff on new technologies and processes
- Established daily huddles to address workflow issues
Implementation: The Ambulatory Transition Project was implemented in phases over a 12-month period:
- Phase 1 (Months 1-3):
- Conducted a thorough Gap Analysis of current workflows and bottlenecks by conducting patient manual time observations.
- Designed the new patient flow system and scheduling practices, standardized the workflow for various disciplines e.g. Registration Clerks, Medial Assistants, and Nurses.
- Began involving the team in creating efficient workflows (we used spaghetti and Fishbone graphs) and training staff on upcoming changes.
- Phase 2 (Months 4-6):
- Rolled out the streamlined registration process, including self-service kiosks
- Implemented the new patient flow system with color-coding and electronic dashboards
- Introduced optimized scheduling practices within the EHR system.
- Phase 3 (Months 7-9):
- Focused on staff training and communication enhancements
- Fine-tuned the EHR systems based on initial feedback and data
- Conducted patient satisfaction surveys to gauge early impact
- Phase 4 (Months 10-12):
- Made final adjustments to all implemented strategies
- Conducted comprehensive data analysis to measure improvements
- Prepared final report and recommendations for potential expansion to other clinics
Throughout the implementation, weekly team meetings were held to address challenges, share successes, and make necessary adjustments. A dedicated project manager oversaw the entire process, ensuring adherence to timelines and facilitating cross-departmental collaboration.
Results:
- Reduction in median patient visit cycle time from 79 minutes to 55 minutes, achieving the goal of visits under 60 minutes (5 minute below target) a 30% improvement.
- Increase in patient satisfaction scores by 36%, as measured by post-visit Press Ganey surveys.
- Improvement in staff satisfaction ratings, with 88% of staff reporting improved work conditions.
- Increase in daily patient capacity from 143 to 150 patients, increasing same day visits.
- Quality of care metrics remained stable or improved, with all metrics showing a 33% enhancement.
- Decrease in no-show rates from 28% to 20%, attributed to improved scheduling and reminder systems.
These results demonstrate the success of the Ambulatory Transition Project in achieving its goals of reducing wait times, improving patient staff satisfaction, and increasing clinic efficiency without compromising the quality of care.
