Quality Improvement, Performance Management, and Outcomes: Lean Six Sigma for Integrated Behavioral Health

The transition to value-based healthcare is shifting reimbursement for integrated behavioral healthcare from fee-for-service to value-based contracts that emphasize improved quality, efficiency, and outcomes. The Lean Six Sigma approaches to quality improvement are well-suited to meet these new criteria. Techniques such as the value stream map, the plan-do-study-act cycle, control charts, and the A3 Report are Lean Six Sigma approaches to quantifying value-based care, evaluating improvements over time, and initiating quality improvement efforts as needed. The competencies covered in this chapter reflect the importance of improving efficiency, decreasing waste, and improving outcomes in integrated behavioral healthcare delivery. Examples of measurement and evaluation of these competencies are included.

[1]  Alexandros Maragakis,et al.  Quality Improvement in Behavioral Health , 2016 .

[2]  A. Bohara,et al.  COMMISSION ON THE ACCREDITATION OF HEALTHCARE ORGANIZATIONS , 2016 .

[3]  Mark Graban,et al.  Lean Hospitals: Improving Quality, Patient Safety, and Employee Satisfaction , 2008 .

[4]  D. Mandell,et al.  Can We Pay for Performance in Behavioral Health Care? , 2017, Psychiatric services.

[5]  P. Kaboli,et al.  Guiding inpatient quality improvement: a systematic review of Lean and Six Sigma. , 2010, Joint Commission journal on quality and patient safety.

[6]  R. Kessler.  Mental Health Care Treatment Initiation When Mental Health Services Are Incorporated Into Primary Care Practice , 2012, The Journal of the American Board of Family Medicine.

[7]  Ashley A. Eggman,et al.  Value-based payment in implementing evidence-based care: the Mental Health Integration Program in Washington state. , 2017, The American journal of managed care.

[8]  Jeanne M. Marrazzo,et al.  More Than Meets the Eye: Associations of Vaginal Bacteria with Gram Stain Morphotypes Using Molecular Phylogenetic Analysis , 2013, PloS one.

[9]  D. Blumenthal,et al.  Measuring Vital Signs: an IOM report on core metrics for health and health care progress. , 2015, JAMA.

[10]  D. Berwick,et al.  The triple aim: care, health, and cost. , 2008, Health affairs.

[11]  James A. Bassuk,et al.  The A3 Problem Solving Report: A 10-Step Scientific Method to Execute Performance Improvements in an Academic Research Vivarium , 2013, PloS one.

[12]  P. Robinson,et al.  Behavioral Consultation and Primary Care: A Guide to Integrating Services , 2006 .

[13]  Christine A. Sinsky,et al.  From Triple to Quadruple Aim: Care of the Patient Requires Care of the Provider , 2014, The Annals of Family Medicine.

[14]  Dennis R Delisle.  Executing Lean Improvements: A Practical Guide with Real-World Healthcare Case Studies , 2015 .

[15]  Luigi Lepanto,et al.  Lean and Six Sigma in acute care: a systematic review of reviews. , 2016, International journal of health care quality assurance.

[16]  H. Pincus,et al.  Quality Measures at the Interface of Behavioral Health and Primary Care , 2016, Current Psychiatry Reports.

[17]  S. Scholle,et al.  Mental Health, Substance Abuse, and Health Behavior Services in Patient-Centered Medical Homes , 2014, The Journal of the American Board of Family Medicine.