Dear Friends and Colleagues,
Welcome back to the IBHI Newsletter. We are pleased to report progress on our initiatives to improve outcomes in care for people suffering from mental illness and substance abuse.
We have been devoting much of our effort to two strategic and inter-related issues: improving care in hospital emergency departments; and developing more integrated approaches to general and behavioral healthcare.
Following are the highlights of some of our work.
Pioneering Collaborative on Improving Care for Behavioral Health Consumers in Emergency Departments — Improving Emergency Department (ED)
The ED Collaborative brings into play the two strategic action areas. After listening to providers, regulators and consumers throughout the country, we selected this study as a collaborative initiative in 2007. Over an eleven month period which ended in November 2008, six pioneering hospitals tested ideas and made significant progress in reducing the overall time patients spent in the ED. The hospitals also tested reduction of agitation of patients, reduction in use of restraints and improvements in achieving connection with community resources. Recruitment is underway for the second cycle in this study, scheduled to begin in 2010. (Click here for a summary of the previous collaborative).
Continuing related work will include:
§ Improving assessment of suicidality, in partnership with the New York State Psychiatric Institute/Columbia University. Appropriately assessing and treating potential suicide was an area identified during the Collaborative, which has an unintended variation in approach and is a major consumer of waiting time. (Click here to visit NYPI http://www.nyspi.org/ )
§ Second and subsequent cycles of the Collaborative will begin both nationally and regionally in 2010.
Seminal 90-day Project — in partnership with the Institute for Healthcare Improvement (IHI) — on Integration of Behavioral Health and Primary Care.
The paper was commissioned for participants in the IHI Triple Aim Initiative, but is applicable far beyond the Triple Aim group. This effort is targeted to organizations who seek to improve simultaneously the patient care experience and health of entire communities, while reducing per capita cost. The paper highlights early-adapter organizations where integration of care is having positive results. The study outlines drivers for successful integration and presents positive aspects of the business case, as well as areas for further research and spread initiatives (Click Here to view the paper )
IBHI has been please to work with partners to improve behavioral health care outcomes. Recent presentations include:
§ Presentation for Disparities Institute National Best Practices Conference (Click here to see the presentation )
§ Presentation for NYS Association of Psychiatric Rehabilitation Agencies 2008 Annual Fall Conference (Click Here to see NYAPRS presentation)
§ Participation in the Institute for Healthcare Improvement Triple Aim Seminar (Click here to see a Summary of the IHI Triple Initiative )
We have also been working with a number of organizations on developing methods to improve the inter-operability of behavioral and general health care.
CHALLENGES AND OPPORTUNITIES
IBHI has been pleased to partner with many innovative and enthusiastic organizations and staff. We are aware that, to date, we have only worked at the periphery of the issues. In some areas, for example, early diagnosis and care of children and adolescents, progress and manpower are in short supply. We welcome your feedback on how we might refine implementation of the initiatives described and particular areas where you might find work productive.
IN THE WORKS
●We have applied for a federal grant to reconvene the leaders of the hospitals which participated in the pioneering ED Collaborative. When this meeting is completed, IBHI intends to restructure the Collaborative and open a second iteration of this project. We expect to recruit hospitals and community groups for this project to begin in 2010.
●IBHI will be participating in an IHI invitation-only seminar on reducing the incidence of re-admission to hospitals. This first-of-its-kind effort promises to offer methodologies for addressing the many issues of poor interoperability of care and ineffective collaboration. Interoperability as defined by Wikipedia means “the ability of diverse systems and organizations to work together (inter-operate). The term is often used in a technical systems engineering sense, or alternatively in a broad sense, taking into account social, political, and organizational factors that impact system to system performance.” When complete, the IHI initiative should open new avenues to reduce the need for high-end care and improve the consumer’s ability to achieve sustained life satisfaction and productivity.
●IBHI will be developing methods for improving care both in general and behavioral health to help address the problem of unnecessary hospital and emergency care admission.
●NY Psychiatric Institute has applied for federal funding for support of a major project on evaluation and intervention in cases of potential suicide. If NYPI is successful, IBHI anticipates a role in this project.
●Recent completion of the 90 Day Project on Integration of Care should facilitate our efforts to support organizations which are successful in competing for the recently offered SAMHSA grants on integration and other organizations challenged by similar demands. IBHI can provide expert support for organizations considering campaigns to improve care connection, especially those not successful with applications for SAMHSA grants.
●The IBHI Board is developing a model set of practice guidelines for serving behavioral health consumers who also have serious chronic diseases (such as diabetes or cardiovascular disease). No systematic set of practice guidelines currently exists, although work has been done on serving chronic disease sufferers and those with serious behavioral health problems.
●The IBHI Board will shortly begin discussion of development of a methodology for adapting the very successful IHI Transforming Care at the Bedside to the inpatient care of behavioral health consumers.
Watch for upcoming conferences and web-inars on our website.
Peter Brown, Executive Director and
Joe Doolittle, Co-Executive Director
FEEDBACK AND CONNECTIONS
Please let us hear from you. We are always interested in your feedback, and value your insights and perspective. So feel encouraged to email us (see below). We’re particularly interested in whether the current work underway fits the need of the behavioral health care community for major improvement. If not, or if you feel another matter or priority exists, please contact us. Of the initiatives described above, is there one or more for which you or your organization would like more information, or in which you would like to participate?
Click on the link below to give us your feed back. Thank you for your time and interest.
Click here for this mini survey. (Below is what you will find when you go to the survey:)
What future project or project (or projects; you can select up to three) from the IBHI agenda do you find important to the behavioral health care field:
□Improving Emergency Department care
□Reducing readmission to high cost services
□Achieving better integration and interoperability of care
□Improving assessment of, and reducing, Suicidality
□Achieving the Triple Aim for Behavioral Health Consumers
□Establishing better practice guidelines for serving consumers with chronic diseases and behavioral health problems
□Improving inpatient care for behavioral health consumers
Please review our website (www.ibhci.org) for more information including how to join IBHI and become more active in our work. Many thanks for your interest and feedback on our mission work and plans.
Please also assist in spreading the word, by forwarding IBHI’s newsletter to any of your peers and colleagues who may be interested.
□ I am interested in future newsletters and updates.
Please send information to me:
Email Address: _____________________________
BOARD OF DIRECTORS
|President||William J. Reidy, MSW
Deputy Director Co-Occurring State Incentive Grant Initiative
District of Columbia Department of Mental Health
|Vice President||Sheila A. Ryan, PhD, RN, FAAN
Professor, Charlotte Peck Lienemann & Alumni Distinguished Chair
Director, International Nursing Education Programs
University of Nebraska Medical Center College of Nursing
|Secretary||Robin Dea, M.D.
Regional Director, Mental Health Services Chair, Chiefs of Psychiatry
Kaiser Permanente Northern California Oakland, CA
|Treasurer||Frederick H. Michel, M.D.
Chief Medical Officer
Pikes Peak Mental Health Colorado Springs, CO
|Board Members||Kathy Muscari, Ph.D. CSW
Consumer Organization & Networking Technical Assistance Center (CONTAC)
|Tammy L. Powell, FACHE
Executive Vice President/Chief Operating Officer
St. Anthony Hospital, Oklahoma City, Oklahoma
|Kathleen M. Reynolds MSW, ACSW
Washtenaw Community Health Organization Ypsilanti, MI
Advisor National Council Community Behavioral Healthcare
|Linda Rosenberg, MSW, LCSW
President and CEO
National Council for Community Behavioral Healthcare Rockville, Maryland
|William Tucker, M.D.
Department of Psychiatry,
Columbia University New York, New York
|Joyce Wale, MSW
Senior Assistant Vice President
New York City Health and Hospitals Corporation New York, NY
|William G. Wood, MD
VP, Associate Corporate Medical Director
AMERIGROUP Corporation Virginia Beach, VA