Featured Project Review

Client: US Army Medical Treatment Facility

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Situation

With an increase in behavioral health injuries and stress-related disorders due to direct interaction with war-related experience, a medical facility for the US Army wished to improve the treatment and health of soldiers and have them return to full duty more efficiently and effectively. However, wait time for walk-in patients often exceeded 120 minutes resulting in patients leaving the facility without being seen. In addition, patients with appointments were seen once every three months, on average. Complicated patients were treated in-house due to the potential for a Medical Evaluation Board (MEB), while uncomplicated patients were directed to the network so that they may be returned to full duty sooner. Before an MEB decision can be made, patients require 5-7 therapeutic sessions over a period of 8-10 weeks. The existing MEB timeline averaged about 18 weeks. Space constraints also limited the number of providers able to see patients. The facility needed to find a low-risk method to improve its system.

Objective

• Ensure no patient leaves without being seen (early departures)•
  
• Shorten time between appointments for individual patients•
  
• Reduce patient waiting time•
  
• Arrive at an MEB decision earlier than 18 weeks•
  

Results

Simulation proved to be an accurate, low-risk tool for analyzing the current state of a Behavioral Health Facility. Sensitivity in the system was identified quickly and the impact of potential changes was easily predicted.

With such clear results, the facility established a triage team (three more resources) from current staffing. This team enabled the treatment of two more patients per hour without hindering current work flow. In addition, patient waiting time has been reduced to less than 30 minutes and no patients leave without being seen.

Further objectives were met by creating the triage team, including reducing patient cycle time by an average of eight minutes per hour, thereby saving 64 minutes per day. Time between appointments was also reduced and patients may now be seen every two and a half weeks rather than every three, thus achieving a 14 week MEB decision point, considerably less than the 18 week previous timeline. This scenario also proved to be the best cost alternative option given space constraints within the facility. Finally, implementing this change revealed better controlled provider utilization times, allowing for the future study, potential reconfiguration, and optimization of the embedded treatment processes in Behavioral Health.

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