1. Accessing a Piece of the Rock Rock County Human Services Change Team Members: Amy Cottington, Sellers Bell, Tracey Bushaw, Marc Donalson, Heather Helgestad, Marnie Hess, Jessica Horkheimer, Jennie Linley, Sue Maurer, Melissa Meboe, Linda Scott-Hoag, and Katherine Zakarias

2. Aim Big: To reduce Re-Hospitalization rates (20%)by increasing access to an appropriate level of mental health services. Small: To reduce time from discharge to intake (4 week wait at baseline) Base line data showed re-hospitalization rates of 38 readmissions of 422 clients over 11 months (3.5 readmissions per month) 30 days = 25 60 days = 13

3. Change: Streamlining our Intake Process PDSAs Increase availability for intake assessments Create single point of access line Determined initial criteria for screening Revision of Screen Revision of Staffing Patterns

4. Effective? Big Aim = not so much (up from 3.5 to 4.4/mo) 30 day  25 to 15 60 day  13 to 9 Psychiatry time Crisis Stabilization Volume Little Aim = Yes! Wait times for assessment down from 4-2weeks Streamlined the intake process and removed from crisis line Developed a screen Developing staffing

5. What Next? Transfer call management to new staff Division Manager to take over sustainability management Out patient services, Crisis, Stabilization Expand services across division Include Kids Determination of Intake Unit and physical space/location

6. Impact Client experience Clear appointment time at time of discharge or call for help Shortened time from request to assessment (4-2 weeks on average) Receive resources indicated via screen Simpler experience when seeking help Infrastructure was Refined for a Single Point of Entry