title: The impact of system level factors on treatment timeliness: utilizing the Toyota Production System to implement direct intake scheduling in a semi-rural community mental health clinic.
abstract: This study examined the effect of using the Toyota Production System (TPS) to change intake procedures on treatment timeliness within a semi-rural community mental health clinic. One hundred randomly selected cases opened the year before the change and 100 randomly selected cases opened the year after the change were reviewed. An analysis of covariance demonstrated that changing intake procedures significantly decreased the number of days consumers waited for appointments (F(1,160) = 4.9; p = .03) from an average of 11 to 8 days. The pattern of difference on treatment timeliness was significantly different between adult and child programs (F(1,160) = 4.2; p = .04), with children waiting an average of 4 days longer than adults for appointments. Findings suggest that small system level changes may elicit important changes and that TPS offers a valuable model to improve processes within community mental health settings. Results also indicate that different factors drive adult and children's treatment timeliness.
authors.affiliation: Curtis Research Center, University of Michigan School of Social Work, 1080 S. University, Ann Arbor, MI, 48109, USA, weaverad@umich.edu.
authors.forename: Addie
authors.initials: A
authors.lastname: Weaver
authors.forename: Catherine G
authors.initials: CG
authors.lastname: Greeno
authors.forename: Donald H
authors.initials: DH
authors.lastname: Goughler
authors.forename: Kathleen
authors.initials: K
authors.lastname: Yarzebinski
authors.forename: Tina
authors.initials: T
authors.lastname: Zimmerman
authors.forename: Carol
authors.initials: C
authors.lastname: Anderson
mesh_terms: D000293:Adolescent; D000328:Adult; D001071:Appointments and Schedules; D002648:Child; D003153:Community Health Services; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services; D008875:Middle Aged; D019035:Rural Health Services; D013997:Time Factors