Friday, September 27, 2013

Same-Day Access Provides Positive Impact on Behavioral Health Services

Last year, we reported that improved access to care has been proven to reduce no-shows and cancellations and better engage persons in mental health and addictions treatment and recovery. To improve access to care, Arizona’s Children Association (AzCA) was one of 56 behavioral health organizations that was chosen to participate in the National Council for Community Behavioral Healthcare’s 2012 Same Day Access Initiative.

AzCA has been working with expert consultants to help persons seeking public mental health and addiction treatment access services quickly and easily. Over the past 12 months, we assessed and redesigned our intake and assessment processes to reduce client wait times. With extreme wait times for patients reaching nearly 300 days at some organizations, a central goal of the initiative is for patients to get appointments for care with their providers when they want them. Studies have found that the longer patients have to wait to get appointments, the more likely they are to cancel or not show up. While a same-day appointment has a 10 percent chance of not being kept, almost a fourth of patients with next- day appointments do not show up.

The changes were made in order to streamline our intake process in behavioral health services and provide more immediate access to our clients. Our goal was to offer same-day appointments for intake assessment and screening for families requesting such services. These services include a full assessment—developmental history, mental health status exam, interim treatment plan, risk assessment, substance abuse assessment, diagnosis, coordination, and suggestions for ongoing services.
Families are now able to contact our office or stop by at their convenience to request services and be seen that same day. In offering services to families the day that they are needed, we can immediately address any safety concerns, develop a treatment plan with the family and provide them with the necessary resources. This process has also allowed us to simplify any paperwork, reduce duplication, and increase consistency across the state. There has also been a fiscal saving of over $10,000 thus far in staff time reduction. AzCA expects that number to continue growing. Because of these changes, staff is now able to be more productive and allot time for meeting other duties and responsibilities.
"It has been very helpful," said Nadia Vega, who schedules behavioral health intakes in Yuma. "We are really growing fast because of the changes and are getting a lot of new referrals, especially from schools. Families are really surprised at how quick and easy the process is. They assume we are going to schedule them a week or two out."
At the beginning of the project, the average number of days wait for the intake was 14 days. The goal was to reduce this to zero by implementing same-day access care. In addition, we have been able to reduce the number of no-show appointments by offering services when the family is in need. Before executing this, no-show rates for intakes were approximately 30 percent. After offering same-day access and allowing consumers to come in when they would like to enroll for services, we reduced our no-show rate to zero for intakes.
“There is less frustration from families with the same-day access to care,” said Lorraine Wallace, who works first-hand with the clients and schedules. “Families are still adjusting to the new process; however, we have gotten great feedback.”
The Council on Accreditation (COA) recently recognized AzCA with an award of excellence for our most recent Quality Improvement Initiative. According to COA, AzCA received the award:
“By demonstrating exceptional improvement initiatives in the management of quality/performance, your organization affirms its ongoing commitment to enhancing organizational effectiveness and excellence for consumers and other stakeholders.”
“By changing our process we have put the child and family’s immediate need at the forefront of our work," said Jessie Gillam, director of operations for behavioral health. "This has been a culture shift for our offices, but has been well-worth the efforts.”
To learn more about AzCA's behavioral health services, visit us online at and click on Our Services.