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2007870130175<br />Transforming the Concept, Process and Environment of the Jim Taliaferro CMHC Evaluation Services Unit<br />Quality Team Day Project Submission <br />Jim Taliaferro Community Mental Health Center<br /><602 S.W. 38th Street, Lawton, Oklahoma  73505<br />Team Members<br />Jim Regan, Executive DirectorJim Taliaferro CMHC(580) 248-5780 x133jregan@odmhsas.orgMike Strickland, MDClinical DirectorJim Taliaferro CMHC(580) 248-5780 x206mstrickland@odmhsas.orgJudy Wallace, QA/PIJim Taliaferro CMHC(580) 248-5780 x129judyw@odmhsas.orgVictor Wilkerson, Director of Inpatient ServicesJim Taliaferro CMHC(580) 248-5780 x165vwilkerson@odmhsas.orgEllie Cruz, Director of NursingJim Taliaferro CMHC(580) 248-5780 x257ecruz@odmhsas.orgJill Melrose, Evaluation Services CoordinatorJim Taliaferro CMHC(580) 248-5780 x138jmelrose@odmhsas.orgRandy Kauk, Triage SpecialistJim Taliaferro CMHC(580) 248-5780 x160rkauk@odmhsas.org<br />Abstract Summary (125 words)<br />Jim Taliaferro Community Mental Health Center utilizes modern process improvement techniques with creative planning and hard work to enhance the quality and cost effectiveness of its Evaluation Services Unit in such a way as to eliminate inappropriate admissions and increase the length of stay by patients to its inpatient unit.  This role change reduced crowding, wait times, and provided better integration with Law Enforcement Agencies by creating a staffing plan that reduces cost and increases coverage during peak admission hours while providing better  patient and staff safety and increasing overall consumer and employee satisfaction.<br />Background Introduction<br />The Jim Taliaferro Community Mental Health Center Triage Unit was established in March 1998 and is now referred to locally as the “Evaluation Services Unit”.  This unit provides consumer screening for mental health issues, substance abuse services, and provides timely crisis interventions for all Oklahomans in our nine county catchment area in Southwest Oklahoma.  The mission of Admission Services is to complete evaluations for all consumers presenting to JTCMHC to determine a diagnoses and assess the type of service that can be provided by our facility to the consumer.<br />Problem/Purpose<br />During the 2009 fiscal year, a severe shortage of physicians made it necessary to admit all consumers presenting to Inpatient under ED status after 5:00 pm daily, as there was no physician available to evaluate them until the following morning. This, in turn, produced an unacceptable number of admissions with stays of less than 24 hours, bringing down the average length of stay from 4-5 days to just 2 days. Because the timeframe for completing all assessments and the interdisciplinary treatment plan is determined by the average length of stay, when we were surveyed in 2008 by CMS we were required by them to change our policy and to complete all assessments and treatment plans in just 48 hours instead of the usual 72. This change made it necessary to have social workers on site 7 days a week, and even so, the 48 hour deadline was not consistently being met, placing our CMS certification in jeopardy. The initial purpose of this project was to eliminate the need to admit consumers who did not meet ED criteria and hopefully to return to our pre-crisis average length of stay.<br />A team comprised of directors and coordinators was designated by the Facility Executive Director to address these issues and provide an economical solution with the following goals:<br />,[object Object]
Reduce crowding, wait times, and the number of patients who leave without being seen.
Improve the Emergency Detention admission process and provide better integration with Law Enforcement Agencies and our Inpatient Unit.
Create a staffing plan that reduces costs and increases coverage during peak hours.

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