There is confusion around access to service, and data demonstrates an average of 186.4 days wait times from assessment to service initiation with case management services in London (not including TCM or Outreach). There is inequity in service access depending on point of first contact.
To decrease “avoidable” wait times to case management services in London from to service initiation (this includes referral to assessment and assessment to service initiation) to under 14 days, by December 1, 2017.
EQIP Support to the Project
- QI coach: Linda Saunders
- Data Coach: Nicole Adkin
Seeking treatment is often a big step for someone dealing with a mental health problem. Access to services starts with an assessment, followed by a wait for services to start. At Canadian Mental Health Association Middlesex, they knew their wait times from assessment to service initiation were too long.
With the support from the EQIP initiative, CMHA Middlesex hopes to reduce the ‘avoidable’ wait times significantly. Run charts for 2015 and 2016 were done to look at the average days waited between assessment and when the client first started receiving services. In 2015, it ranged from 150 days to up to 225 days. In 2016, it was as low as less than 100 days and as high as 250 days.
The team then used a Fishbone diagram, the 5 Whys tool and a Driver Diagram to identify root causes. Based on what they learned through the diagnostic tools, they developed a future state process map so that the entire team could visualize where they were going and what they were aiming for.
[sidenote]Not only will this reduce the wait time for services, it will also improve the patient experience and the continuity of care.[/sidenote] The biggest change that is being implemented as a result of this QI project is that CMHA Middlesex is creating a new service model. Specifically, intake workers will become case managers which will help in avoiding the need for clients to tell their story multiple times, create more connection to the crisis service and have seamless follow up with those accessing those services. Not only will this reduce the wait time for services, it will also improve the patient experience and the continuity of care. CMHA Middlesex hopes to spread this shift in job function even further, to improve more services for clients.
CMHA Middlesex experienced some resistance to the idea of a QI project at the outset. But that shines the light on an important lesson, explains Jennifer Dowsett, “There was some staff resistant at first, but by participating in the process, we were able to build trust and cooperation, and we’re pleased that our team is on board now.” Now they hope to spread their learning across the organization.