
Lean Behavioral Health
The Kings County Hospital Story
Joseph Merlino(Editor)
Oxford University Press Inc
Published on 27. February 2014
Book
Paperback/Softback
288 pages
978-0-19-998952-2 (ISBN)
Description
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.
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.
Reviews / Votes
"Quality of care transformation has arrived for behavioral health care with this pioneering volume, Lean Behavioral Health. This is the case study of how the Toyota approach to safety and quality can dramatically improve psychiatric inpatient and outpatient care. All behavioral health leaders, administrators, and clinicians should read this book for inspiration and practical tools to change the way they treat patients and manage their care deliverysystems."
-- Steven S. Sharfstein, MD, President and CEO, Sheppard Pratt Health System and Clinical Professor of Psychiatry, University of Maryland
"This book describes the lean journey NYCHHC mental health providers have walked and the remarkable results they have achieved. The NYCHHC mental health leaders and practitioners inspire us all by explaining how the poorest and most vulnerable in our society can receive much better care, not by adding more money to the system, but by rethinking the system. Their efforts to redesign healthcare with the patient at the center is a model for the rest of our nation
to emulate."
-- John Toussaint, MD, Founder and CEO of ThedaCare Center for Healthcare Value
"Lean Behavioral Health is a compelling story of deep change told by the people who led and lived the transformation. It describes how the behavioral health division of Kings County Hospital, a public hospital within the vast New York Health and Hospital Corporation 'safety net' system, pulled itself out of crisis by learning to apply lean improvement methods to its broken systems and waste-laden processes. This dramatic turnaround narrative is a 'must
read' for behavioral health professionals who aspire to improve the services they deliver."
-- John E. Billi, MD, Associate Vice President of Medical Affairs, University of Michigan
More details
Language
English
Place of publication
New York
United States
Target group
Professional and scholarly
Illustrations
51 illustrations
Dimensions
Height: 234 mm
Width: 156 mm
Thickness: 15 mm
Weight
436 gr
ISBN-13
978-0-19-998952-2 (9780199989522)
Copyright in bibliographic data and cover images is held by Nielsen Book Services Limited or by the publishers or by their respective licensors: all rights reserved.
Schweitzer Classification
Other editions
Additional editions

E-Book
01/2014
1st Edition
OUP eBook
€49.99
Available for download

E-Book
01/2014
1st Edition
OUP eBook
€49.99
Available for download
Persons
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.
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.
Author
Senior Vice President, Organizational Innovation and EffectivenessSenior Vice President, Organizational Innovation and Effectiveness, New York City Health and Hospitals Corporation, New York, NY, USA
Senior Associate Executive DirectorSenior Associate Executive Director, Kings County Hospital Center Behavioral Health Services, New York, NY, USA
Editor
Deputy Executive Director and Director of PsychiatryDeputy Executive Director and Director of Psychiatry, Kings County Hospital Center Behavioral Health Services, New York, NY, USA
Content
Table of Contents ; Preface ; 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 ; Conclusion ; Jill Bowen, PhD ; Joseph P. Merlino, MD, MPA ; Joanna Omi ; Epilogue: Insights of a Psychologist turned Lean Facilitator ; Kristen Bauman, Ph.D. ; Index