The Role of Lean Process Improvement in Implementation of Evidence-Based Practices in Behavioral Health Care

  • Bradley Steinfeld
  • Jennifer Scott
  • Gavin Vilander
  • Larry Marx
  • Michael Quirk
  • Julie Lindberg
  • Kelly Koerner
Article

Abstract

To effectively implement evidence-based practices (EBP) in behavioral health care, an organization needs to have operating structures and processes that can address core EBP implementation factors and stages. Lean, a widely used quality improvement process, can potentially address the factors crucial to successful implementation of EBP. This article provides an overview of Lean and the relationship between Lean process improvement steps, and EBP implementation models. Examples of how Lean process improvement methodologies can be used to help plan and carry out implementation of EBP in mental health delivery systems are presented along with limitations and recommendations for future research and clinical application.

References

  1. 1.
    McHugh RK, Barlow D. The Dissemination and Implementation of Evidence Based Treatments. American Psychologist, 20130, 65, 73-84.Google Scholar
  2. 2.
    National Institute of Clinical Excellence, Depression: Management of Depression in Primary and Secondary Care (Clinical Guideline 23). London, Nice 2004.Google Scholar
  3. 3.
    Shahran R, Clark DM, Fairburn CG, et al. Mind the Gap: Improving the Dissemination of CBT. Behavior Research Therapy, 2009, 47,902-902.CrossRefGoogle Scholar
  4. 4.
    Silverman WK, Hinshaw SP. The Second Special Issue on Evidence Based Psychosocial Treatments for Children and Adolescents. Journal of clinical Child and Adolescent Psychology, 2008, 27, 1-8.CrossRefGoogle Scholar
  5. 5.
    Fixsen DL, Naoom SF, Blasé KA, et al. Implementation Research: A Synthesis of the Literature, 2005. Tampa: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network.Google Scholar
  6. 6.
    Beidas RS, Kendall P. Training Therapists in Evidence Based Practice: A Critical Review of Studies from a Systems Contextual Practice. Clinical Psychology Science and Practice, 2010, 17, 1-30.PubMedCentralCrossRefPubMedGoogle Scholar
  7. 7.
    Fixen DL, Blasé L, Naoom SF, et al. Core Implementation Components, Research on Social Work Practice, 2005, 5, 531-540.Google Scholar
  8. 8.
    Herschell AD, Kolko DJ, Baumann BL, et al. The Role of Therapist Training in the Implementation of Psychosocial Treatments: A Review and Critique with Recommendations. Clinical Psychology Review, 2010, 30, 448-466.PubMedCentralCrossRefPubMedGoogle Scholar
  9. 9.
    Aarons GA, Hurlburt M, Horwitz SM. Advancing a Conceptual Model of Evidence Based Practice Implementation in Public Service Sectors, Administrative Policy Mental Health, 2011, 38, 4-2.CrossRefGoogle Scholar
  10. 10.
    McHugh RK, Barlow D. Dissemination and Implementation of Evidence-Based Psychological Interventions, 2012, New York, Oxford Press.Google Scholar
  11. 11.
    Damschroder L, Aaron D, Keith R, et al. Fostering Implementation of Health Services Research Findings into Practice: A Consolidated Framework for Advancing Implementation Science. Implementation Science, 2009, 4. 50.Google Scholar
  12. 12.
    Regan J, Daleiden EL, Corpita B. Integrity in Mental Health Systems: An Expanded Framework for Managing Uncertainty in Clinical Care. Clinical Psychology: Science and Practice, 2013, 20, 78-95.Google Scholar
  13. 13.
    Tenant C, Roberts PA. Hoshan Kanri: A Technique for Strategic Quality Management. Quality Assurance, 2000, 8, 77-99.Google Scholar
  14. 14.
    Resar RK. Making Noncatastrophic Health Care Processes Reliable: Learning to Walk Before Running in Creating High-Reliability Organization. Health Services Research; 2006, 41:1677-1689.PubMedCentralCrossRefPubMedGoogle Scholar
  15. 15.
    Kasul RA, Motwani JG. Successful Implementation of TPS in a Manufacturing Setting: A Case Study, Industrial Management and Data Systems, 1997, 97, 274-279.CrossRefGoogle Scholar
  16. 16.
    Womack JP, Jones DT. Lean Solutions: How Companies and Customers Can Create Value and Wealth Together. New York: Free Press, 2005.Google Scholar
  17. 17.
    Spear SJ. Fixing Health Care from the Inside, Today, 2005, Harvard Business Review, 83, 78-91.PubMedGoogle Scholar
  18. 18.
    Weaver Al, Greeno C, Goughler DH, et al. 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. Journal of Behavioral Health Services & Research, 2013, 10: 294-395.Google Scholar
  19. 19.
    Reid RJ, Coleman EA, Johnson. et al. The Group Health Medical Home at Year Two: Cost Savings, Higher Patient Satisfactions and Less Burnout for Providers, Health Affairs, 20120, 29, 835-843.Google Scholar
  20. 20.
    Bongar B, Sullivan G. The Suicidal Patient: Clinical and Legal Standards of Care, Third Edition, 2013. Washington, D.C. APA PressGoogle Scholar
  21. 21.
    Landes SJ, Linehan MM. Dissemination and Implementation of Dialectical Behavioral Therapy: An Intensive Training Model in R.K. McHugh and D. Barlow (Eds) Dissemination and Implementation of Evidence-Based Psychological Interventions, New York, Oxford Press, 2012.Google Scholar
  22. 22.
    Linehan MM. Skills Manual for Treating Borderline Personality Disorder. 1993. New York: Guilford PressGoogle Scholar
  23. 23.
    Vest JR, Gamm LD. A Critical Review of the Research Literature on Six Sigma Lean and Studer Group’s Hardwiring Excellence in the United States: The Need to Demonstrate and Communicate the Effectiveness of Transformation Strategies in Healthcare, Implementation Science 2008, 7, 4-35.Google Scholar
  24. 24.
    Quirk MP, Soman MP, Erikson M. et al. The Adaptive Leadership Conversation, 2011, Group Practice Journal, February 13-21.Google Scholar
  25. 25.
    Hogan R, Kaiser RB. What We Know About Leadership, Review of General Psychology, 2005, 9 (2), 169-180.CrossRefGoogle Scholar
  26. 26.
    Ebert L, Amaya Jackson L, Markiewicz J. et al. Development and Application of the NCCTS Learning Collaborative Model for the Implementation of Evidence-Based Child Trauma Treatment in R.K. McHugh and D. Barlow (Eds), Dissemination and Implementation of Evidence-Based Psychological Interventions. New York, Oxford Press, 2012Google Scholar
  27. 27.
    Forehand R, Dorsey S, Jones DJ. et al. Adherence and Flexibility: They Can (and Do) Coexist. Clinical Psychology: Science and Practice, 20120, 17, 258-263.Google Scholar
  28. 28.
    Rotheram-Borus MJ, Swendeman D, Chorpita B. Disruptive Innovations for Designing and Defusing Evidence-Based Interventions. American Psychologist, 2012, 463-476.Google Scholar
  29. 29.
    Toussaint M. Writing the New Playbook for U.S. Health Care: Lessons from Wisconsin, Health Affairs, 2009, 28/ 1343-1350.Google Scholar

Copyright information

© National Council for Behavioral Health 2014

Authors and Affiliations

  • Bradley Steinfeld
    • 1
  • Jennifer Scott
    • 2
  • Gavin Vilander
    • 3
  • Larry Marx
    • 4
  • Michael Quirk
    • 5
  • Julie Lindberg
    • 6
  • Kelly Koerner
    • 7
  1. 1.Group Health CooperativeTacomaUSA
  2. 2.Children’s HospitalSeattleUSA
  3. 3.Group Health CooperativeSpokane 99201USA
  4. 4.Group Health CooperativeSeattleUSA
  5. 5.SeattleUSA
  6. 6.Molina Healthcare of WashingtonBothellUSA
  7. 7.Evidence Based Practice InstituteSeattleUSA

Personalised recommendations