Estimating the Impact of Staffing and Clinical Decisions on Wait Times for Child and Adolescent Mental Health Services

Abstract

Background: The Choice and Partnership Approach was recently implemented at the three IWK Community Mental Health and Addictions outpatient community clinics in part to manage increasing demand on services. Positive results have been reported in past literature but questions remained about system flexibility and factors to maintain timely access to care. Objective: To measure the relative contributions that various system factors have on increasing wait times. Methods: Discrete event simulation was used to model the study clinic and modify system factors. Analysis examined the relative differences in wait times and the percent of clients that attained wait time benchmarks associated with changing system factors. Results: Number of Partnership appointments, and the percent of clients continuing to Partnership session had the largest impact on increasing wait times. Conclusions: Specific system factors may be overlooked when attempting to mitigate increases in wait times, but day-to-day processes have a significant impact on system level outcomes.