1. OUTPATIENT CLINIC FOR CHILDREN AND YOUTH Onondaga County Dept. of Mental Health

2. PDSA – What did you do and why? Reduced number of calls from consumers who request phone in prescription refills Without losing our distinction as a safety net clinic. Increased number of psychiatry hours available for face-to-face assessments and apptmts.

3. Decision Support – What Happened and How do you Know? Worked with therapists and docs to document cost of call- in behavior in terms of lack of access for new consumers. Presented change as an experiment. Developed letter to consumers that included safety net features but did not support call in behavior. Rolled out letter to all consumers. Stuck with it!

4. Decreased calls for phone med refills by 600% Increased doc time avail for apptmts by 8% Results

5. Able to see 8 new families with additional doc hours

6. Doc time that used to generated $0.00 now earns @ $10,400 annually.

7. The Plan for Sustainability Original letter is being given to each new consumer at time of first psychiatry appointment. Therapists reinforce the message of plan ahead for your convenience and your childs safety and well- being. Experiment proved new process works without harm to consumers.

8. Cultural Impacts/Considerations Stigma that our clients lead chaotic lives and cannot plan ahead has proven to be false in all but 1% of population. Culture of safety net is compatible with concept of personal responsibility for most families. In a crisis, the safety net still works!