PS 1997; 48:1578-1581
Copyright © 1997 by American Psychiatric Association
A spreadsheet method for calculating maximum caseload and intake capacity for CMHC psychiatrists
JG Baker
Mental Health Mental Retardation Authority of Harris County, Houston, TX 77002, USA.
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.
