Daily Management System to Improve Performance in a Behavioral Health Primary Care Practice

Daily Management System (DMS) is a quality improvement tool based on daily team meetings and visual management with input from physicians, nurses, clerical staff, and management to facilitate a data driven; action oriented, engaged, and empowered team of problem solvers. The team identifies performance metrics, sets goals, uses problem solving skills, implements small changes, and measures impact of those changes. We provide an introduction to DMS and describe our experience in a primary care practice located in the Behavioral Health building of a large urban public hospital. These efforts resulted in an increase in first appointment of the day starting on time from 3% in September 2014 to 58% in September 2015. Our efforts to decrease No Show Rate have resulted in modest success to date (50% to 40%). Our problem solving process has resulted in improved understanding of the issues involved and revealed new potential solutions. Our experience demonstrates the feasibility of implementing DMS in a primary care setting and supports the hypothesis that DMS is a cost effective tool that can be used to identify and improve key performance metrics. These tools and lessons learned can serve as a starting point for any practice looking to implement a similar quality improvement process.