How "Lean" Management Techniques Were Applied at One of the Country's Largest Behavioral Healthcare Providers
New Book Captures Commitment to Improving Quality and Safety at Hospitals and Clinics
Jun 23, 2014
The New York City Health and Hospitals Corporation (HHC) today announced the availability its new book chronicling HHC’s implementation of Lean management to improve the quality of care and safety of behavioral health patients at HHC’s Kings County Hospital Center in Brooklyn, one of the largest providers of behavioral healthcare in the country.
The book, Lean Behavioral Health: The Kings County Story, published by Oxford University Press, is the first book devoted to Lean with a specific focus on addressing the unique challenges within behavioral health. While Lean has been used in other sectors for decades, its application in health care is still relatively new and developing.
Lean management, with roots in manufacturing, presented healthcare organizations with a practical system for maximizing an organization’s ability to improve the quality of care and strengthen the bottom line by eliminating waste and improving the flow of services to patients. For the past seven years, HHC has been working with Simpler Consulting, a leading global management consulting firm, to incorporate the transformational approach of Lean in nineteen of its hospitals, community health centers and long term care facilities. Kings County Hospital Center, a member facility of HHC, adopted a Lean approach to remodel its behavioral health services to ensure a safe and clinically appropriate environment after a tragic death in its emergency room in 2008.
“When we started the Lean transformation at Kings County, we were faced with very clear and defining challenges including a tragic death, a Department of Justice investigation and the need for improved communications between providers,” said Joseph P. Merlino, MD, MPA, Deputy Executive Director for Behavioral Health Services and Director of Psychiatry at Kings County Hospital Center. “By keeping patients our first priority, involving our community and continually demonstrating a strong commitment from hospital leadership, front line workers, clinicians and staff, we have built an exciting new, sustainable model of care that can serve as a powerful example for others in the healthcare industry.
Employing Lean, Kings County Hospital Center was able to make major improvements in both patient care and revenue management, reducing the average triage time in its Comprehensive Psychiatric Emergency Program (CPEP) from one hour to 16 minutes; reducing average length of stay in the CPEP from 24 hours to less than 14 hours; and increasing the monthly revenue it its adult mental health clinic by 76 percent. Overall, HHC has realized over $415 million in savings since it first began employing Lean throughout its organization in 2007.
In this book, readers will learn about:
- Principles of Lean and its development and application at HHC;
- Challenges and opportunities in adopting Lean in behavioral health, including key learnings of what has and has not worked;
- New Kings County Hospital Center service delivery and operational model and how it is being recognized as a center for transformation and quality.
The book is edited by Dr. Merlino, Joanna Omi, HHC’s Chief Innovation Officer and Senior Vice President for Organizational Effectiveness, and Jill Bowen, PhD, Senior Associate Executive Director and Chief of Staff for Behavioral Health Services at Kings County Hospital Center. It is available to purchase at http://simpler.com/en-us/learning-center/publications and on Amazon.com. All proceeds of the book go to The Fund for HHC, which supports innovative, effective and compassionate programs that help HHC care for the residents of New York City.
About the Editors
Joseph P. Merlino, MD, MPA, is the Deputy Executive Director for Behavioral Health Services and director of Psychiatry at Kings County Hospital Center. He is also a Professor of Psychiatry at the State University of New York – Downstate Medical College and Adjunct Professor of Psychiatry and Behavioral Sciences at New York Medical College, Distinguished Life Fellow American Psychiatric Association and Fellow, American College of Psychiatrists.
Joanna Omi is Chief Innovation Officer and Senior Vice President for Organizational Effectiveness at the New York City Health and Hospital Corporation.
Jill Bowen, PhD, is a Senior Associate Executive Director and Chief of Staff for Behavioral Health Services at Kings County Hospital Center.
Ian Michaels (HHC) (212) 788-3339
About NYC Health + Hospitals
The NYC Health + Hospitals health care system is a $6.7 billion integrated healthcare delivery system, the largest municipal healthcare organization in the country, and one of the New York area’s largest providers of government-sponsored health insurance, MetroPlusHealth Health Plan, the plan of choice for nearly half a million New Yorkers. The NYC Health + Hospitals health care system serves 1.4 million New Yorkers every year and more than 475,000 are uninsured. The system provides medical, mental health and substance abuse services through its 11 acute care hospitals, five skilled nursing facilities, six large diagnostic and treatment centers and more than 70 community based clinics. NYC Health + Hospitals/Home Care also provides in-home services for New Yorkers. The NYC Health + Hospitals system was the 2008 recipient of the National Quality Forum and The Joint Commission’s John M. Eisenberg Award for Innovation in Patient Safety and Quality. For more information, visit www.nychealthandhospitals.org or find us on https://www.facebook.com/NYCHealthSystem or twitter.com/NYCHealthSystem.