1. Reduce Waiting & No-Shows  Increase Admissions & Continuation www.NIATx.net Q-ing and U Queueing theory is your business! Andrew Quanbeck, MS NIATx 200 Scientific Manager STAR-SI Data Coordinator

2. Reduce Waiting & No-Shows  Increase Admissions & Continuation www.NIATx.net Why should I care? If you have a phone at your office, this applies to you! Do you schedule intake appointments or “slots”?

3. Reduce Waiting & No-Shows  Increase Admissions & Continuation www.NIATx.net Enter queueing theory What is a “queue?” Historical roots Some basics Arrival rate Service rate Does queueing = rationing?

4. Reduce Waiting & No-Shows  Increase Admissions & Continuation www.NIATx.net What is this all about? “Things happen in threes” “When it rains, it pours”

5. Reduce Waiting & No-Shows  Increase Admissions & Continuation www.NIATx.net The world is a random place Like it or not, we live in a random world Human beings have an innate urge to superimpose patterns where they don’t really exist (e.g., lottery numbers, coin flips, stock market, etc.) We like schedules, order, and routine Wouldn’t it be nice if it rained exactly ¼” every night at 11 pm and then stopped?

6. Reduce Waiting & No-Shows  Increase Admissions & Continuation www.NIATx.net Demonstration Imagine you are starting up a program Based on sound market research, you expect 25 requests for service per month In a given month with roughly 25 work days, that means an average of one intake request per day Implication: set aside one intake “slot” each morning, Monday-Friday

7. Reduce Waiting & No-Shows  Increase Admissions & Continuation www.NIATx.net Demonstration (continued) This approach is: –Logical –Very common in the field –DOOMED What REALLY happens?

8. Reduce Waiting & No-Shows  Increase Admissions & Continuation www.NIATx.net Implications

9. Reduce Waiting & No-Shows  Increase Admissions & Continuation www.NIATx.net The inevitable results of “slot” systems… Waiting time ebbs and flows, but on average grows infinitely (a fixed system can never catch up) No-shows Poor efficiency Financial distress

10. Reduce Waiting & No-Shows  Increase Admissions & Continuation www.NIATx.net Takeaways No appointments for intake processes! Think people, not “slots” The more scheduling control you try to exert, the more out of control things will get Make functional roles as interchangeable as possible through cross-training Serving customers must be staff’s #1 priority at all times

11. Reduce Waiting & No-Shows  Increase Admissions & Continuation www.NIATx.net Don’t “blame it on the rain!” Understanding the true nature of your business is the key to organizational survival! Don’t let bad processes put you out of business

12. Reduce Waiting & No-Shows  Increase Admissions & Continuation www.NIATx.net So much for theory- how about reality? www.niatx.net – click on “Success Stories” then “Business Case Series” Three agencies that went to walk-ins: –Acadia Hospital –Central New York Services –Southwest Florida Addiction Services What happened?

13. Reduce Waiting & No-Shows  Increase Admissions & Continuation www.NIATx.net Q&A Who has done/tried walk-in intakes? How did you get started? What issues did you face? What were the results?