Measuring to improve management of demand capacity how

Measuring to improve management of demand capacity – how important is it? Ruth Glassborow Quality and Efficiency Support Team

DCAQ Quick Revision

Demand in Mental Health services Team No of Referrals Average Contact Time Per Referral Demand in Hours CMHT 20 10 200 Crisis Team 10 25 250 The amount of time needed to respond to those referrals that chose to use your service

There are Different Types of Demand Actual Demand Created Demand Failure Demand Hidden Demand Influence and manage the demand for your service by reducing created and failure demand

Capacity How much work you can do in a given time period Not the same as activity – what you actually do

Server Server Queue: people waiting to be seen Queue type A Queue type B

DCAQ Summary Waiting list, queue Demand = what we should have done = All requests for a service = what we should do Capacity = what we could do Activity = what we did

Ideally you want to effectively understand manage • Demand • Capacity • Activity • Queue

So how important is data to effectively manage demand capacity?

Its really important but… there is lots you can do without it

DCAQ Work Examples of things you can do without data

Managing DCAQ without data – Set specific treatment goals – Implement effective caseload management review systems – Map your processes and take out un-necessary steps – Make effective use of group work – Effectively manage sickness – Ensure staff appropriately trained so have skills to do work that presents – Manage meetings effectively

Managing DCAQ without data – Set clear eligibility criteria – Implement choice booking – Ensure admin staff have full access and booking permission for clinic diaries – System in place for un-used appointment slots to be filled quickly – Clear DNA and CNA policies – Make effective use of telephone contacts – Ensure systems to step-up and step-down

Managing DCAQ without data

DCAQ Work Areas where data can help you make improvements

At the most basic level Unless you can measure your demand you capacity you have no way of showing if there is a mismatch

New to follow/up rates – highlighting opportunities for improvement? Average No of Sessions (Okiishi, 2006) Most Effective Least Effective 5 6 7 12 5 12 12 9 13 10

DNA Rates – highlighting opportunities for improvement? Did Not Attend (DNA) East Lothian Psychology East Lothian Therapists 1 st Assessment DNA rate 15. 5% 19% Average hours lost per week due to 1 st Ass. DNA 1. 4 2. 7 Follow-up DNA rate 11% 12. 2% Average hours lost per week due to follow-up DNA 3. 3 4 Average hours lost per week to DNAs 4. 7 6. 7

Non Clinical Activity Audit - highlighting opportunities for improvement?

Clinical outcomes data – highlighting opportunities for improvement? Outcome Most Effective Least Effective Recovered 22% 11% Improved 22% 17% Deteriorated 5% 11% 8 11 Average Sessions per Client Okiishi et al, 2006

Referral analysis - highlighting opportunities for improvement?

Summary

We recommend You start working your data so you can effectively measure DCAQ but… parallel to this you make sure that you are addressing all of the things you can do without data.