Impact of policy and process design on the performance of intake and treatment processes in mental health care: a system dynamics case study

For most of its history, medical care has been a customized process. Because customized processes might not lead to optimal performance, health-care managers are considering business process redesign, implementation of standardized (brief) therapies, stepped care, and policy changes to solve supply chain management issues. We develop a system dynamics model to support the management of intake and treatment processes in mental health care. We first model the existing situation in the care unit (Base Scenario of customized care) and simulate the impact of policy changes (assigning scarce personnel resources to different care activities) and redesign of intake and treatment processes (implementing brief therapies and stepped care). We show that shifting personnel resources between intake and treatment activities does not substantially improve performance. We found better results of process redesign and stepped care (+42% client intake rate and +18% revenues per day). Journal of the Operational Research Society (2010) 61, 1437-1445. doi:10.1057/jors.2009.110 Published online 30 September 2009