1. HUTCHINGS PSYCHIATRIC CENTER CHILDREN AND YOUTH OUTPATIENT CLINIC

2. PDSA – What did you do and why?
*Plan: Reduce the frequency of requests for prescriptions between medication appointments.
Step #1: Collect baseline data for 4 consecutive weeks on the frequency of these requests before and then after instituting a new procedure.
Step #2: Worked with 2 physicians, social worker and clerical staff to define new procedure.
Step #3: Re-educate staff and families regarding new procedure.
* Rationale: Increase the time for physicians to see patients (productivity). Increase the likelihood that patients attend their medication appointments.

3. Decision Support – What Happened and How do you Know?
Gave a letter to families regarding new procedure.
Only wrote bridge scripts to next medication appointment.
Poster in waiting room indicating that 2 days notice was needed for prescriptions between medication appointments.
Data was collected for a 4 week period before the changes were instituted and for another 4 week period after the procedures were instituted.
After the new procedures were instituted there was a 54% decrease in requests for prescriptions between medication appointments.

4. The blue bars represent 4 consecutive weeks prior to the procedure being instituted. The magenta bars represent 4 consecutive weeks after the procedure was instituted.

5. Business Case and/or Strategic Advantage for the Organization
Increased the amount of available time for physicians to see patients (productivity).
Increased compliance with medication appointments.
Improved service delivery.
Gave families more responsibility for planning which resulted in fewer emergency prescriptions.

6. The Plan for Sustainability
Have clinicians review procedure with each new intake.
Have the secretary inform the clinician when patient/family cancel medication appointment.
Therapists will coordinate re-scheduling medication appointments.
Have poster in waiting area.