1. Measuring to improve management of demand and capacity – how important is it? Ruth Glassborow Quality and Efficiency Support Team

2. DCAQ Quick Revision

3. TeamNo of Referrals CMHT20 Crisis Team10 Average Contact Time Per Referral 10 25 Demand in Hours 200 250 Demand in Mental Health services The amount of time needed to respond to those referrals that chose to use your service

4. Influence and manage the demand for your service by reducing created and failure demand There are Different Types of Demand Actual Demand Created Demand Failure Demand Hidden Demand

5. Capacity How much work you can do in a given time period Not the same as activity – what you actually do

6. Server Queue type AQueue type B Queue: people waiting to be seen

7. Capacity = what we could do Activity = what we did Demand = All requests for a service = what we should do Waiting list, queue = what we should have done DCAQ Summary

8. Ideally you want to effectively understand and manage Demand Capacity Activity Queue

9. So how important is data to effectively manage demand and capacity?

10. Its really important but… there is lots you can do without it

11. DCAQ Work Examples of things you can do without data

12. Managing DCAQ without data –Set specific treatment goals –Implement effective caseload management review systems –Map your processes and take out un-necessary steps –Make effective use of group work –Effectively manage sickness –Ensure staff appropriately trained so have skills to do work that presents –Manage meetings effectively

13. Managing DCAQ without data –Set clear eligibility criteria –Implement choice booking –Ensure admin staff have full access and booking permission for clinic diaries –System in place for un-used appointment slots to be filled quickly –Clear DNA and CNA policies –Make effective use of telephone contacts –Ensure systems to step-up and step-down

14. Managing DCAQ without data

15. DCAQ Work Areas where data can help you make improvements

16. At the most basic level Unless you can measure your demand and you capacity you have no way of showing if there is a mismatch

17. New to follow/up rates – highlighting opportunities for improvement? Average No of Sessions (Okiishi, 2006) Most EffectiveLeast Effective 512 6 79 13 510

18. DNA Rates – highlighting opportunities for improvement? Did Not Attend (DNA)East Lothian PsychologyEast Lothian Therapists 1 st Assessment DNA rate 15.5%19% Average hours lost per week due to 1 st Ass. DNA 1.42.7 Follow-up DNA rate 11%12.2% Average hours lost per week due to follow-up DNA 3.34 Average hours lost per week to DNAs 4.76.7

19. Activity Audit - highlighting opportunities for improvement? Non Clinical

20. Clinical outcomes data – highlighting opportunities for improvement? OutcomeMost EffectiveLeast Effective Recovered22%11% Improved22%17% Deteriorated5%11% Average Sessions per Client 811 Okiishi et al, 2006

21. Referral analysis - highlighting opportunities for improvement?

22. Summary

23. We recommend You start working your data so you can effectively measure DCAQ but… parallel to this you make sure that you are addressing all of the things you can do without data.