ABSTRACT
This chapter provides series of tools to assist in guiding operational improvements. It focuses on Lean healthcare methodology. Patients with a psychiatric condition should be treated no differently than a patient with chest pain. Care plans should be individualized with medications and treatments tailored to the individual patient. Of all areas in emergency medicine, cultural biases are most evident in the care of psychiatric patients. The first step in starting a project is having a core leadership team. Once leaders are identified, it is time to create the "emergency department (ED) psychiatry flow team". Metrics in emergency psychiatry can be divided into several categories: operational, quality, diagnosis specific, and demographic and cost metrics. Metrics allow tackling the problem one small step at a time with continuous improvement. One of the best ways to use knowledge obtained in a value stream map is with a Kaizen event. Kaizen events are improvement events that span 3–5 days with specific targets for improvement.
