where have all the people gone? Increase the occupancy of the Crisis Stabilization Unit (CSU)

1. A Rapid-Cycle Change Project to Increase Admissions where have all the people gone?Increase the occupancy of the Crisis Stabilization Unit (CSU)

2. WHERE HAVE ALL THE PEOPLE GONE? A Rapid-Cycle Change Project to Increase Admissions Westbrook Health Services, Inc. is a comprehensive community behavioral health center serving individuals with mental health, substance abuse and developmental disabilities in eight counties in West Virginia.

3. WHERE HAVE ALL THE PEOPLE GONE? A Rapid-Cycle Change Project to Increase Admissions Mission Statement Empowering people to achieve their greatest potential, Westbrook Health Services, Inc. is the industry leader in providing comprehensive care to individuals with mental health, developmental, substance abuse and addiction challenges.

4. WHERE HAVE ALL THE PEOPLE GONE? A Rapid-Cycle Change Project to Increase Admissions • serves an 8 county area with a total population of 168,800 • 7,796 individuals served annually

5. WHERE HAVE ALL THE PEOPLE GONE? A Rapid-Cycle Change Project to Increase Admissions • serving individuals with mental • health and substance abuse • issues (detox) • 10 beds • voluntary admission • average length of stay is 7 days • annual budget of $810,000 Crisis Stabilization Unit

6. WHERE HAVE ALL THE PEOPLE GONE? A Rapid-Cycle Change Project to Increase Admissions What keeps the CEO awake at night? answer: a low occupancy rate at the CSU

7. WHERE HAVE ALL THE PEOPLE GONE? A Rapid-Cycle Change Project to Increase Admissions The aim of the change project was to

8. WHERE HAVE ALL THE PEOPLE GONE? A Rapid-Cycle Change Project to Increase Admissions The Change Team Suzanne Evans CSU Director and team leader Tim Barnett Adult Mental Health Program Director and referral source Heather Williams CSU Administrative Assistant and data queen Abby Pierce Crisis Coordination Case Manager and referral source

9. WHERE HAVE ALL THE PEOPLE GONE? A Rapid-Cycle Change Project to Increase Admissions The Issue For a 6 month period (2-1-09 through 7-31-09) prior to the initiation of the change project the CSU operated at an average of 50% occupancy.

10. WHERE HAVE ALL THE PEOPLE GONE? A Rapid-Cycle Change Project to Increase Admissions The Goal Increase the occupancy rate of the CSU to 70%.

11. WHERE HAVE ALL THE PEOPLE GONE? A Rapid-Cycle Change Project to Increase Admissions The Business Case At 50% occupancy the revenue of the CSU was approximately $2,680 a day. Increasing the occupancy to 70% would increase the revenue to $3,752 a day, an increase of $1,072 a day. Bottom line – a 20% increase in occupancy would result in a 40% increase in revenue.

12. WHERE HAVE ALL THE PEOPLE GONE? A Rapid-Cycle Change Project to Increase Admissions The Walk-through The walk-through revealed that the CSU staff members were taking too much time to respond to referrals for admission and admissions were being lost to other agencies who responded more quickly.

13. WHERE HAVE ALL THE PEOPLE GONE? A Rapid-Cycle Change Project to Increase Admissions Plan Increase occupancy at the CSU by decreasing the wait time for a response when a referral is made.

14. WHERE HAVE ALL THE PEOPLE GONE? A Rapid-Cycle Change Project to Increase Admissions Do The CSU staff will take no more than 15 minutes to respond to a referral with a yes or no answer, accept or not accept.

15. WHERE HAVE ALL THE PEOPLE GONE? A Rapid-Cycle Change Project to Increase Admissions Study For the period that the change was implemented, the occupancy rate at the CSU increased from 50% to 70%.

16. WHERE HAVE ALL THE PEOPLE GONE? A Rapid-Cycle Change Project to Increase Admissions Act Implement the change. The CSU staff will continue to respond to referrals for admission within 15 minutes or less.

17. WHERE HAVE ALL THE PEOPLE GONE? A Rapid-Cycle Change Project to Increase Admissions What We Learned Our referral sources reported to us that they were pleased with the shorter response time, even if the referral was not accepted for admission, and that they would be more inclined to refer patients to the CSU in the future.

18. WHERE HAVE ALL THE PEOPLE GONE? A Rapid-Cycle Change Project to Increase Admissions Sustainability Plan The CSU staff are recording the time that a referral is received and the time that a response is given on each referral form. The CSU director is reviewing the response time for each referral.

19. WHERE HAVE ALL THE PEOPLE GONE? A Rapid-Cycle Change Project to Increase Admissions Sustainability Plan cont. The occupancy rate of the CSU is continually monitored by the CSU administrative assistant and reported to the change team and the CSU staff every 2 weeks.

20. WHERE HAVE ALL THE PEOPLE GONE? A Rapid-Cycle Change Project to Increase Admissions Sustainability Plan cont. The change team intervenes if the occupancy rate of the CSU falls below 60% for a 4 week period.

21. WHERE HAVE ALL THE PEOPLE GONE? A Rapid-Cycle Change Project to Increase Admissions Contact Information Suzanne L. Evans, M.A., LSW Crisis Stabilization Unit Program Director 2121 7th Street Parkersburg, WV 26101 304-485-1721, ext. 159 slevans@westbrookhealth.com