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