OBJECTIVE: A method was sought to help administrators of community
mental health centers determine a level of psychiatric staffing that is
both cost-efficient and ensures high quality of care. METHODS: A survey of
staff psychiatrists was conducted at a large community mental health center
with seven outpatient clinics. The survey measured variables that can
affect staffing requirements, including the number of hours psychiatrists
have available for direct care, their preferred intervals between a
patient's return visits, and the duration of appointments for an initial
psychiatric assessment and for medication maintenance. A computer
spreadsheet was developed to calculate the caseload capacity and intake
capacity for clinics of the center. RESULTS: The survey indicated that the
psychiatrists at the center had an average of 33 hours a week available for
direct care. The mean preferred time between a patient's medication
maintenance visits was 7.3 weeks. The mean time required for a psychiatric
assessment was 80 minutes, and for a medication maintenance visit it was 33
minutes. With these data, the spreadsheet method was used to calculate
intake and caseload capacity for psychiatric staff at three of the center's
clinics. CONCLUSIONS: The data-based approach to calculating capacity can
be modified to meet local needs. It brings objectivity to decision making
about staffing, and the methods can improve resource management and enhance
relationships between stakeholders and physicians.
Abstract Teaser