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Milwaukee County Behavioral Health
Division NIATx Project 2015
Increasing Referrals to Outpatient Treatment;
Reducing Emergency Room Recidivism
Team Members: Emily Kenney, Amy Moebius, Andre Gilliam, Dr. Kelly Wahlen,
Sean Ryan, Natasha Wortham, Amy Lorenz, John Hyatt
Project Aim
• Big Aim: Reduce inpatient psychiatric admissions and readmissions.
• Little Aim: Increase patient hand offs from PCS/OBS to Access Clinic to 10 clients per month by August 15, 2015.
Changes
• The Old: Patients were told to come to Access Clinic between 8am-4pm, Monday-Friday on a walk-in basis to access outpatient treatment.
• The New: • While still in our care, we helped patients make an outpatient appointment at
the Access clinic for the same day or the very next day.
• Patients were given a reminder/appointment card.
• A script was developed and a caring message was assembled that informed patients of the helpful benefits of continuing care.
• Doctors and nurses involved in the discharge plan- further engaging both in the process.
Results
• 500% increase in referrals to 12 per month
• 64% show rate (Note: We do not know the exact show rate from before as we just started tracking)
• Of those who showed, 93% had not gone back to PCS vs. 73% of those who did not show• Estimated $7,713 in savings by a reduction in recidivism
• Marked increase in doctor satisfaction- being able to have an appointment quickly makes a big difference to their disposition
• Increase in communication across systems
Next Steps
• We are choosing to adopt this model and expand it• Keep same day/next day appointment capability and add “walk-over”
• Give access to same day/next day to the Crisis Mobile Team, especially when considering dropping and emergency detention
• Continue to consider other groups who could use this collaboration
• Add “What to Expect” sheet for patients • Gather patient satisfaction data
• Need to look into reducing barriers to showing up
• AODA diagnosis
• ED vs. voluntary status
• Transportation
• Walk-over vs. Later appointment
Impact
• Definitely beneficial for staff• Increase in communication across systems.
• Doctors are more confident that patients have a good plan and are well taken care of. Their disposition and our ease in working with them increased.
• Estimated savings of $7,713 per month
• Results were presented to the new County Mental Health Board and received a round of applause