Improving access to frontline psychosocial services for youths in difficulty by using LSS: an action research case study

Abstract

Purpose This study aims to improve accessibility to frontline psychological services for youths in difficulty. In the province of Quebec, Canada, the first significant intervention must take place within 30 days for at least 75% of the clients. Achieving this target is challenging. This was observed in the Youth Programme of a health-care network in Montreal (Centre Intégré (Universitaire) de la Santé et des Services Sociaux Centre-Sud-de-l’île-de-Montréal). Design/methodology/approach Lean Six Sigma (LSS) approach within the Action Research methodology was used. Define, Measure, Analyse, Innovate, Implement and Control structure combined with Lean techniques and a Kaizen event were implemented. Findings In total 69% of the clients have now had their first intervention within 30 days and 91% within 60 days. Improving accessibility to frontline services led to improving accessibility to second-line services. Communicating performance objectives to employees led to increasing their awareness about the importance of performance assessment and their willingness to contribute to improvement. The Kaizen event was a driving force that enabled more collaboration and trust. The participation of a partner-client in the Kaizen helped finding client-centred solutions. The large number of participants in the Kaizen added complexity. Research limitations/implications It was difficult to sort and rank a large number of solutions during the Kaizen. The impact of hiring additional employees has not been investigated. Despite the significant improvements, the targets were not achieved. More research is required to identify more accurately critical factors that have a major impact on the success of LSS projects involving complex processes. Originality/value This study contributes to the body of knowledge in Lean health care. It describes Lean tools/techniques used, solution implementation and improvements achieved in a real context. 10 success factors and 4 challenges were identified. The study provides a model for other organizations for developing their own roadmap to improve accessibility to their services, notably in large and complex processes.