Carlsbad Mental Health Center and M.T.M. Services Announce Practice Management Collaboration
Noel Clark, CEO of Carlsbad Mental Health Center (CMHC) and David Lloyd, Founder and President of M.T.M. Services (MTM) whose offices are located in Raleigh, NC, have announced a collaborative effort that will provide service process measurement to support rapid cycle change design and implementation to address practice management challenges for community providers in New Mexico.
The purpose of the collaboration is to provide joint consultation support and resources to address specific challenges to the delivery of direct services at the community level in New Mexico.
Noel Clark, CEO and John Bain, COO of the CMHC will provide to the consultation collaborative local market awareness and experience/expertise with developing and implementing a rapid cycle change initiative that has produce significant positive outcomes for CMHC. In the fall of 2007, CMHC was presented with the opportunity to participate with the National Council for Community Behavioral Healthcare in the Access and Retention Initiative. With that came the relationship with David Lloyd and the other MTM team members and a business concept known as Rapid Cycle Change Implementation. While CMHC was very much vested in the process of changing CMHC from a non-profit association model to a more business oriented practice management non-profit company, much of this change was slow coming. CMHC recognized the necessity for the culture of CMHC for change to be planned, organized and “rapid”. Together with MTM, CMHC created and implemented rapid cycle implementation plan (RCIP). Concurrently, CMHC made the mental switch from a data system into an information system that is the foundation for our rapid cycle change model. Using the SPQM Measurement Information system coupled with our RICP, we now have a model and methodology that allows CMHC to Plan, Do, Study and Act (PDSA) and implement responsive change rather than reactionary change, and do so in a very timely manner.
Some of the outcomes achieved during the one year grant participation from September 2007 through August 2008 are:
1. By better managing no shows/cancels and scheduling rates, CMHC increased capacity for outpatient and medical services by over 20%.
2. Access to Care Enhancement:
a. Same Day Access to Intake: In January 2008, CMHC introduced same day access to a clinical intake for all consumers.
b. CMHC’s goal of less than 10 days to first appointment access with a master’s level clinician and medical personnel was reach in November 2008. By August 2008, CMHC reported an 11.2 day average to see a master’s level clinician and 11.1 day to see the psychiatrist/NP. It is important to note that our nurse practitioners and psychiatrists were booked out in excess of six weeks at the beginning of 2008.
3. Revenue Increases: CMHC experienced a 22% revenue increase during the one year period.
4. CMHC service providers have benefited greatly from implementing the concurrent documentation technique. Although few have implemented this method 100%, they all use it to some great degree and morale has improved remarkably.
5. Completion of paperwork/documentation within 24 hours of service delivery is up to about 72% from 50% one year ago. The amount of paperwork completed 10 days late or more is down from 10% to 1% for the same period.
6. Productivity incentives for the last quarter ending 6/30/08 were the highest ever paid by CMHC and for the first time all but one clinician earned their bonus.
The MTM Team brings to the consultation collaboration a national perspective. MTM has provided local, regional and statewide practice management consultation through the National Council of Community Behavioral Healthcare to over 450 community mental health centers in over 35 states during the past 15 years. Based on this experience, several key barriers to delivering timely, cost effective and quality services have been identified nationally as outlined below:
1. Lack of Objective Based Practice Management Performance Data/Information to support more timely and empowered decision-making can be addressed through the use of the SPQM Measurement Consultation service.
2. Establishing Cost Based Productivity Standards for Direct Service staff by addressing Indirect/Non-Billable Activity compared to Direct Service/Billable Service level
3. Reduce documentation hours to direct/billable service ratio by Standardizing documentation processes across the agency to support:
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systems learning and time effectiveness
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conversion to Electronic Medical Record
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implementation of the Concurrent Documentation Technique
4. Enhance Access to Care by reducing number of intake processes, process flow barriers, redundant collection of information and total staff time needed per intake to treatment plan process in order to reduce costs in line with fee-for-service revenues available
5. Addressing No Show/Cancellation levels in clinic and in community
6. Developing Centralized Scheduling to ensure adequate Schedule Rate to accommodate an increased Referral Demand
7. Addressing Active Caseloads vs. Carrying Cases model
8. Reduce Travel Time Hours compared to Direct/Billable Service Hours
9. Adopt “Customer Service” focus to support better definition of Support/Clerical staff roles vs. Direct Care staff roles
10. Reduce meetings to Direct Service Ratio by moving to solution focused meetings
11. Provide training for supervisors to become managers/leaders through coaching/mentoring supervision model.
12. Rapid Cycle Change Initiative Design and Implementation Planning
MTM will provide sample solutions to these identified service delivery barriers which will shorten the practice management change time required.
The MTM team has experience in designing and implementing practice management and service process quality improvement initiatives for Community Behavioral Healthcare Organizations nationwide. This experience will be complimented by CMHC’s experience locally in New Mexico.
If your center is interested in discussing how the practice management consultation collaborative can assist your local direct care challenges, please contact:
Noel Clark at email address: noel@cmhcnm.com
David Lloyd at email address: mtmserve@aol.com
More information about MTM is available at web site here.
