Lean Behavioral Health: The Kings County Hospital Story

ISBN : 9780199989522

Joseph Merlino; Joanna Omi; Jill Bowen
288 ページ
157 x 234 mm

Lean Behavioral Health: The Kings County Hospital Story is the first lean book that focuses entirely on behavioral health. Using the principles of the Toyota Production System, or lean, the contributors in this groundbreaking volume share their experience in transforming a major safety net public hospital after a tragic and internationally publicized event. As the largest public healthcare system in the United States, the New York City Health & Hospitals Corporation adopted lean as the transformational approach for all of its hospitals and clinics. Kings County Hospital Center, one of the largest providers of behavioral health care in the country, continues on its transformational journey utilizing lean's techniques. While not every event was fully successful, most were and every event, including failures, increased the knowledge base about how to continually improve quality and safety. Having made major changes, Kings County Hospital Center is now recognized as a center for transformation and quality receiving high marks from oversight agencies. This volume begins by describing the basic principles of the lean approach-adding value, eliminating waste, and tapping the organization's line staff to create and sustain dramatic change. An overview of the use of lean from a quality improvement perspective follows. Lean tools are applied to many services that comprise the behavioral health value stream and these stories are highlighted. The experts in identifying waste and adding value are the line staff whose voices are captured in the clinical chapters. Insights learned by event participants are emphasized as teaching points to provide context for what has worked or has not worked at Kings County Hospital Center. While the burning platform at Kings County Hospital Center was white hot and while the Department of Justice scrutinized its quality of patient care, the application of lean methods and tools has transformed the hospital into a potential model for behavioral health programs facing the challenges of the present healthcare environment. It is a must-have story for clinicians, administrators and other leaders in the mental health field devoted to improving quality and safety at their hospitals and clinics.


Table of Contents
Chapter One: Why Lean in Health Care - People Aren't Cars
Joanna Omi
Bruce Smith
Ameer Robertson, Esq.
Chapter Two: Behavioral Health Care and Lean
Joanna Omi, Joseph P. Merlino, MD, Joyce B. Wale, LCSW, Kristen Bauman, PsyD, Olga Deshchenko, Antonio D. Martin
Chapter Three: Lean, Safety, and Quality
Robert Berding, Esq., L.M.H.C., C.R.C.
Renuka Ananthamoorthy, MD
Lora Giacomoni, RN
Chapter Four: Financial Benefits of Lean
Marlene Zurack
George Proctor
Chapter 5: Lean in Behavioral Health
Joseph P. Merlino, MD, MPA
Kristen Baumann, PhD
Jill Bowen, PhD
Chapter 6: CPEP
Kristen Baumann, Ph.D
Regine Bruny-Olawaiye, M.D
Richard Freeman
Chapter 7: Lean and Inpatient Psychiatry
Roumen N Nikolov, MD
Akinola Adebisi, MD
Linda Paradiso, RN, NPP
Chapter 8: Outpatient Services: The Adult Mental Health Clinic
Jill Bowen, PhD
Lancelot Deygoo, MSCE
Chapter 9: Lean applications: the Medical Home Model
Claire Patterson
Janine Perazzo
Akinola Adebisi
Jill Bowen, PhD
Joseph P. Merlino, MD, MPA
Joanna Omi
Epilogue: Insights of a Psychologist turned Lean Facilitator
Kristen Bauman, Ph.D.


Joseph Merlino is the chief executive for behavioral health services and Director of Psychiatry at Kings County Hospital Center, where he leads the transformation efforts of the largest public hospitals in New York. He is also Professor of Psychiatry at the State University of New York - Downstate Medical College. He is on the Board of Directors for the Group for the Advancement of Psychiatry. ; Joanna Omi is chief innovation officer and senior vice president for organizational innovation and effectiveness at the New York City Health and Hospitals Corporation (HHC). Ms. Omi provides leadership and operational guidance to Breakthrough, the HHC Enterprise-wide Improvement System. She is responsible for the development and adoption of lean throughout HHC's various healthcare facilities and corporate offices. Prior to her current position, Ms. Omi was HHC's Senior Assistant Vice President for Corporate Planning and HIV Services. In this capacity, she led the Corporation's planning efforts and managed special projects, including the Corporate Ambulatory Care Restructuring Initiative, the Community Health Care Demonstration Project, HIV/AIDS programs and development of the first federally qualified health center on Staten Island.; Jill Bowen is the senior associate executive director and chief of staff for Behavioral Health Services at Kings County Hospital Center. Trained as a clinical psychologist, she has been employed at Kings County Hospital Center for the past 26 years, in a variety of roles involving direct care, supervision and administration, strategic planning and program development for the department. She has played a significant role in the transformation of the services provided in the Behavioral Health department across the continuum of care.