Abstract：
This retrospective, observational report describes an innovative quality improvement process, Phase-based Care (PBC), that eliminated wait times and achieved positive clinical outcomes in a community mental health center\'s (CMHC) mood disorder clinic without adding staff. PBC accomplishes this by eliminating the ingrained cultural practice of routinely scheduling stable patients at rote intervals of 1-3 months, regardless of clinical need or medical necessity. Based on four organizational transformations and using mathematical algorithms developed for this process, PBC re-allocates therapy and medical resources away from routinely scheduled appointments and front-loads those resources to patients in an acute phase of illness. To maintain wellness for patients in recovery, lower frequency and intensity approaches are used. This report describes the development of the PBC methodology focusing on the Rapid Recovery Clinic (RRC) comprised of 182 patients with a primary diagnosis of a mood disorder, the largest of the 14 PBC clinics created. Over an 18-month period, wait times were reduced from several months to less than one week and recovery rates, meaning no longer in an acute phase, were 63% and 78% at weeks 6 and 12, respectively for patients who engaged in the program.
摘要：
这次回顾，观察报告描述了一个创新的质量改进过程，分阶段护理(PBC)消除了等待时间，并在社区精神卫生中心（CMHC）的情绪障碍诊所取得了积极的临床结果，而无需增加工作人员。PBC通过消除根深蒂固的文化惯例来实现这一目标，即定期按1-3个月的时间间隔安排稳定的患者。无论临床需要或医疗需要。基于四个组织转换，并使用为此过程开发的数学算法，PBC将治疗和医疗资源从常规的预约中重新分配，并将这些资源预先加载到疾病急性期的患者。为了保持康复患者的健康，使用较低频率和强度的方法。本报告描述了PBC方法的发展，重点是快速康复诊所（RRC），该诊所由182名主要诊断为情绪障碍的患者组成。创建的14个PBC诊所中最大的。在18个月的时间里，等待时间从几个月减少到不到一周，恢复率，意味着不再处于急性期，参与该计划的患者在第6周和第12周分别为63%和78%。
