Access to Care Redesign: Live Webchat with Scott Lloyd of MTM Services

by Rebecca Farley on November 28, 2011

On Monday, November 27, the National Council is holding a webinar with Scott Lloyd, President of MTM Services, on “Improving Access to Care: Eliminate No Shows and Wait Times.”

As community behavioral health organizations face continued pressure to step up efficiency in operations and clinical practice, this webinar will provide information on how you can streamline your access-to-care process and remain at the cutting edge. Through the National Council’s Access Redesign Initiative, participating behavioral health organizations have implemented same day access policies to decrease no-shows and cancellations, reminder programs to encourage patients to keep their appointments, and reduction in documentation. They’ve generated significant increase in savings, reduced staff time, cut client wait times, and strengthened client engagement. During this webinar, Access Redesign faculty and participants will share lessons on how your organization can improve access to care.

After the webinar, Scott Lloyd will join us on MentalHealthcareReform.org for a live webchat with readers. Click to continue reading and learn how to participate in the web chat.

The webchat will take place from 4:30-5:00 pm eastern time. Participating in the webchat is simple:

1. Leave your question in the comments section below this post.

2. Hit F5 on your keyboard OR the Refresh button in your internet browser to view your comment if it does not automatically appear.

3. Scott will reply to your question in the comments section. You may have to refresh your page (see #2 above) to view his response. If he is unable to respond during the allotted time, please check back to the blog over the next few days as he responds to any remaining questions.

Questions about how this works? Email Rebecca at RebeccaF@thenationalcouncil.org, and I will get back to you as soon as I can.

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{ 32 comments… read them below or add one }

Rebecca Farley November 28, 2011 at 11:18 am

Welcome to our live webchat with Scott Lloyd, President of MTM Services! Please submit your questions by using the comments box below.

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paula childers November 28, 2011 at 2:02 pm

Are there grants available to organizations to be able to hire your firm? If so please describe. Thanks!

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Scott Lloyd November 28, 2011 at 2:34 pm

Different grant opportunities do become avaialable via the National Council. You would would need to contact them and/or visit their web site (http://www.thenationalcouncil.org/) to see what opportunities are coming up.

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paula childers November 28, 2011 at 2:14 pm

We couldn’t participate except to listen to the webinar – can we get handouts/ppt. slides? Thanks.

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Rebecca Farley November 28, 2011 at 2:16 pm

A recording of the webinar, along with the PowerPoint slides, will be available on the National Council’s website within the next few days: http://www.thenationalcouncil.org/cs/recordings_presentations

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Robin Hogue November 28, 2011 at 2:30 pm

I am particularly interested in the ongoing issue of addressing high no-show/cancel rates in ongoing therapy. Do you have other recommendations for change in this area?

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Scott Lloyd November 28, 2011 at 2:39 pm

Robin:

We work with teams on the importance of having a no show policy that is enforceable, without putting your organization at risk. In addition, we work with teams on the importance of 48 hour reminder calls that are live calls so the client can be offered a chance to reschedule if needed.

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Brenda Chupp November 28, 2011 at 2:31 pm

Is there a template available for how to document content in collaborative documentation that not only works well with engagement with clients but also satisfies documentation requires for JCAHO and insurance companies establishing medical necessity.

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Scott Lloyd November 28, 2011 at 2:44 pm

I would suggest that you visit the Massachusetts (MSDP), New York (NYSCRI), and/or Oregon (OSCRI) form web sites to see the Symptoms, Intervention, Response, and Plan (S.I.R.P.) notes that they have created. All of these sites can be accessed from the bottom of our home page via: http://www.mtmservices.org

The forms allow for the progress note to be written in a conversational model, that works very well and offers very compliant notes when used correctly.

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Cindy Byrd November 28, 2011 at 2:32 pm

Can you explain how the concurrent documentation would be used with children under the age of 5? Would you complete the documentation with the caregeiver at the end of the session instead of the child?

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Scott Lloyd November 28, 2011 at 2:47 pm

Completing the note with the caregiver/guardian is a very common approach. Another approach is to confirm if there is a way to capture their response to your work by pointing to different happy or sad dolls, smiley faces versus frowning faces, etc.

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Bettina Bernstein November 28, 2011 at 2:33 pm

Can you explain adaptations of concurrent documentation for Autistic Spectrum population?

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Scott Lloyd November 28, 2011 at 2:51 pm

Bettina:

Similar to the response given above in regard to using CD with children, I would work with your staff to confirm how they are wrapping their sessions now. More specifically, what are they doing at the end of a session to confirm where the client is in regard to the work completed that day, and document that response. If the client is not able to comprehend or respond, then reviewing and documenting with their guardian or care giver would be another option.

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Noelle Scott November 28, 2011 at 2:36 pm

How do we apply the collaborative documentation and scheduling concepts to a community-based intensive mental health system in which there are multiple staff participating in treatment sessions with the youth/family?

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Scott Lloyd November 28, 2011 at 2:56 pm

Noelle:

Thanks for your question. It would depend on the technology you have available to you in your environment. The Massachusetts (MSDP) and New York (NYSCRI) progress note sets that can be accessed from our home page (www.mtmservices.org) contain intensive care notes for delivery of multiple services in a day. These notes are able to be utilized in a paper model as well as an electronic record, however an electronic record make it much easier.

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Mary Lou Fahey November 28, 2011 at 2:38 pm

We have access for intakes on my team but then consumers are placed on a waitlist to see a clinician for on-going treatment. Have you run into this before and is your model effective with dealing with treatment waitlists? Or do you know of resources that address this issue?

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Scott Lloyd November 30, 2011 at 2:48 pm

The short answer is yes, we deal with this every day to help teams create Episode of Care and/or Level of Care Criteria that allow them to establish when a client should be APPROPIATELY discharged. The beast resource we have found nationally to complete this work is Willa Presmanes, M.Ed., M A, who is now a member of our firm. Here is her email address; I think you will find her very helpful! Willa.Presmanes@mtmservices.org

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Jim Wilkerson November 28, 2011 at 2:39 pm

Hi Scott, we have been very successful with open access at our main site. Our smaller sites, which serve 500 and 1000 clients, we have had more issues with. Are there other models than the rotating staff mentioned?

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Scott Lloyd November 30, 2011 at 3:02 pm

Thanks for your question. The main thing to look at in smaller sites is the total staffing need tied to demand. I will send you a simple calculator that allows you to establish this quickly, and that will then allow you to determine your staffing needs.

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Petrina Nelson November 28, 2011 at 2:39 pm

Would you provide an example “script” for transitioning to collaborative documentation on the website?

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Scott Lloyd November 30, 2011 at 3:03 pm

Thanks for your question. Here is a sample script to use so that the client knows what to expect and is not surprised.

“We are going to utilize a new note taking strategy during our session today. Instead of me taking notes after the session by myself, we will take notes together at the end of the session which will allow us to focus and agree on what was accomplished.”

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Vivian Jackson November 28, 2011 at 2:40 pm

Have you tracked the degree to which these improvements have influenced racial and ethnic disparities in engagement?

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Scott Lloyd November 30, 2011 at 3:28 pm

Thanks for your question; however I would need more clarification to answer it. If I understand you correctly, you are talking about non-English speaking clients? If that is correct, we have found this works the same as we simply are reviewing what we are documenting with them verbally. We have seen some teams that have gone to the expense of having dual screens with a translation program that actively displays English on one screen and their native language on the other; however there is still an element of trust required. Finally, the numbers from the CD work we have done include all races, services domains, etc., and we have never seen a large difference in the numbers based upon racial or ethnic disparities.

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sarah November 28, 2011 at 2:41 pm

what types of technology are you suggesting for organzations?

do you suggest specific vendors based on technology needed?

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Scott Lloyd November 30, 2011 at 3:36 pm

Thanks for your question. We use a lot of technology, and yes we definitely have suggested/recommended vendors based upon what you are trying to accomplish. Obviously, proper set up and vendor selection is a large key in your long term success.

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Ann November 28, 2011 at 2:41 pm

How do we effectively apply the collaborative documentation in a group setting without taking up a significant amount of the therapists time?

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Scott Lloyd November 30, 2011 at 3:38 pm

Thanks for your question. Please make sure the read Jalane’s response below. In addition, I would add that the main thing about CD in a group is that all you are doing is taking brief notes/paraphrasing the group member’s response to your standard group wrap up. So the time needed is no/not much different than what is being done now.

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Jalane Christian-Stoker November 28, 2011 at 2:47 pm

We hold many groups in our agency…and keep the attendance at high levels (14-16 clients enrolled) to justify using two clinicians. One is responsible for the documentation of the group note into each client’s electronic health record. the other clinician is actually running the group and managing the curriculum for the group.

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Susan Josephson November 28, 2011 at 2:48 pm

Can you please describe how concurrent documentation can work in a group (both groups of children and groups of adults)?

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Scott Lloyd November 30, 2011 at 3:42 pm

Thanks for your question. Please make sure the read Jalane’s response above. In addition, I would add the same thing as I said above: The main thing about CD in a group is that all you are doing is taking brief notes/paraphrasing the group member’s response to your standard group wrap up. So the time needed is no/not much different than what is being done now.

How you would utilize the note is based upon the technology you do or do not have. If you have an Electronic Record that will write a group note for all participants at once, this is totally different than an organization that is utilizing paper notes…..So, it really is organization specific.

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Jennifer Froemel November 28, 2011 at 2:53 pm

Can you please post your powerpoint of the webinar?

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Rebecca Farley November 28, 2011 at 2:59 pm

The slides from the webinar will be available within the next few days at http://www.thenationalcouncil.org/cs/recordings_presentations

Reply

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