Home Health Big Book of Emergency Department Psychiatry
Increase the Rate of Service
The basic principle here is standardized workflows to decrease non-value added time by workers: always consider practices that are better for the patient but easier for the people doing the work. Avoid overproduction of patients (e.g., unnecessary testing).
Strategies for increasing the rate of service:
Reduce Variation in Service
It is impossible to remove all variation since there is such diagnostic diversity in this patient population. That said, there are ways to minimize variation:
See Chapter 5 on care options and treatment teams for a detailed discussion of how this will work in an ED psychiatry program.
Reduce Variation in Arrivals
This will require some creativity in emergency psychiatry arrivals. As we discussed before, arrivals occur in a Poisson process so not much can be done for ED arrivals except partnerships with law enforcement and local agencies to provide access. There can, however, be decreased arrivals to other queues that the patient goes through. An excellent example is unnecessary lab testing. If we avoid this, it creates a more standardized process with less variation in blood draws to this server.
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