Topics for Today Introductions AIMS and Pediatric Cohort - PowerPoint PPT Presentation

Topics � for � Today • Introductions � – AIMS � and � Pediatric � Cohort Getting � Ready � for � • Overview � of � Training � and � TA Measurement � Based � Care • Overview � of � Principles � and � Models • Choosing � a � Registry � Tool Presented � by: �������������� Debra � Morrison • Developing � Workflows � (time � allowing) UW � AIMS � Project Manager � and � Practice � Coach 3 AIMS � Center � Introductions � AIMS � Center � Implementations � & � Trainings Debra � Morrison Project � Manager � and � Practice � Coach WA � State � BHI � & � CoCM • Policy • Bree � Collaborative • Medicaid � Transformation Training � and � Support • Anna � Hink, � LICSW Integrated � Care � Training � Program • Healthier � WA � Practice � Clinical � Trainer Transformation � Support � Hub • Opioid � Treatment � Network Largest � WA � State � BHI � Implementations • MHIP • UW � Medicine • Anna � Ratzliff, � MD, � PhD Providence � ACO � (4 � regions) Psychiatric � Trainer Juliann � Salisbury Program � Coordinator 5

CPAA � Pediatric � Cohort � Introductions � CPAA � Pediatrics � Cohort � Introductions 1 � minute � each! � Tell � us � one � GOAL � Northwest � Pediatric � Olympia � Pediatrics you � have � for � Center 1 � site � in � Olympia implementing �� 2 � sites � in � Centralia 7 � Pediatricians 9 � Pediatricians 2 � ARNPs Measurement � What � will � you � 5 � ARNPs 0 � BH � staff � (hoping � LICSW � Based � Care. � or � Clinical � Psychologist MEASURE � to � see � if � 1 � Clinical � Psychologist GOAL: 1 � LMHC you � are � achieving � GOAL: that � GOAL? 6 7 CPAA � Pediatrics � Cohort � Introductions AIMS � Center � Training � at � a � Glance � South � Sound � Pediatric � Skagit � Pediatrics Associates � and � Catholic � 1 � site � in � Mt � Vernon Coaching � & � Training Community � Services 7 � Pediatricians • New � content � introduced � through � webinars �� and � In � Person � Clinician � 1 � site � in � Olympia practiced � in �� follow � up � 2 � ARNPs Training case � conference � calls � Planning � for � Integration • Coaching � calls � for � BH � • Focus � on � BH � professionals 6 � Pediatricians ? � BH � Staff • Engaging � patients � and � driving � clinicians � and � psychiatric � • Calls � with � clinic � /org � leaders � providers active � treatment � to � target 2 � ARNPs to � determine � key � areas � for � GOAL: • Ad � hoc � support � for � PCP � • Using � a � registry � to � prioritize � planning � and � training � education � & � engagement and � manage � a � patient � caseload • Involve � primary � care � team � • Ad � hoc � support � for � work � 1 � LMHCA • Using � psychiatry � time � and � PCP � flow � course � corrections effectively � or � working � • Develop � or � fine � tune � GOAL: effectively � with � psychiatric � screening � and � treatment � consultants � workflows • Effective � primary � care � team � • Orientation � for � BH � clinicians � communication and � psychiatric � consultants • Emphasis � on � practice � and � • Support � sustainability active � learning 8

In � Person � BH � Clinician � Training � Planning � for � Integration Feb � 5 � 6 � 2019 • Implementation � Team � Calls �� Debra BH � Clinician � Training– Anna � H � and � Anna � R • Webinars � for � All � team � members � – Debra/Team • New � roles � and � responsibilities � for � care � team o Getting � Ready � for � Measurement � Based � Care � • Patient � engagement � strategies o Workflow � Development • Using � a � registry � for � population � management o Screening � Protocols � for � Pediatric � Populations • Driving � active � treatment � to � target o Registry � Training • Team � communication � and � culture � change � working � in � • Introductory � Call � for � Psychiatric � Consultants � Anna � new � settings Ratzliff 10 11 Post � Launch � Coaching � and � Training Focus � on � Principles • Implementation � Team � Coaching � calls � to � support � Bree � Collaborative � Recommendations � operations � changes � Debra + • Clinical � coaching � calls � and � webinars � for � BH � Clinicians � AIMS � Principles � of � Collaborative � Care and � Psychiatric � Consultants � – Anna � H � and � Anna � R = • Access � for � all � to � CPAA/AIMS �� training � website Principles � For � Evidence � Based � BH � Integration � QUESTIONS? � 12 13

Bree � Collaborative � Recommendations Principles � of � Collaborative � Care 1. � Integrated � Care � Team Client-Centered Collaboration . Primary care and mental health providers collaborate effectively using shared care plans. 2. � Patient � Access � to � Behavioral � Health � as � a � Routine � Part � of � Care Population-Based Care. A defined group of clients is tracked in a registry so that no one falls through the cracks. 3. � Accessibility � and � Sharing � of � Patient � Information 4. � Practice � Access � to � Psychiatric � Services Treatment to Target. Progress is measured regularly and treatments are actively changed until clinical goals are achieved. 5. � Operational � Systems � and � Workflows � to � Support � Population � Based � Care Evidence-Based Care. Providers use treatments that have 6. � Evidence � Based � Treatments � (meds � and � BH � Interventions) research evidence for effectiveness. 7. � Patient � Involvement � in � Care Accountable Care. Providers are accountable and reimbursed 8. � Data � for � Quality � Improvement for quality of care and clinical outcomes, not just volume of care. Most � Common � Models � of � Care � in � WA Principles � for � Evidence � Based � Integration • BH � provider � key � part � of � team � BHC/PCBH �� Model Collaborative � Care � Model • Systematic � screening • BH � Provider � and � Psych � Consultant � • BH � Consultant � on � PCP � team • Measurement � based � behavioral � health � services • Aim � for � timely � access, � address � MH � • Aim � for � immediate � access, � address � conditions many �� health � conditions • Population � based � care � • Initial � Assessment � followed � by � brief � • Brief � visits, � focus � on � immediate � visits, � focus � on � symptom � alleviation • Treatment � to � target � concern � of � PCP � or � patient • Assertive � BHP � follow � up � until � specific � clinical � targets � reached � • Patient/PCP � initiate � follow � up � care • Tracking � patients � and � following � up � • Average � “episode” � around � six � • No � defined � “episode � of � care” months � • Evidence � based � treatments � provided • • Psychiatric � services � usually � by � Regular �� (weekly) � psychiatric � case � review � – treatment � modifications! external � referral � if � at � all • Access � to � psychiatry � (Bree) � vs. � psychiatric � case � • Measurement � , � tracking, � treatment � • Measurement � and � tracking � may � be � modification � integral � to � model review � (CoCM) new � elements 16

Psychiatric � Consultant � Role � in � CoCM Reflection � and � Discussion Psych � Caseload � Review Optional � Ideal � Tasks 3 � minutes � to � discuss � with � your � team 1 � minute � to � report • Routine � schedule � (ideally � • Education � sessions � for � weekly) PCPs � about � diagnoses � or � medications • Prioritize � patients � that � are � • Which � model � are � you � planning � to � not � improving, � complex � • Availability � for � urgent � new � patients consults implement? • Continuity � of � care • Ability � to � see � especially � • How � do � you � intend � to � provide � psychiatric � complex � patients � in � person � • Access � to � chart � in � EMR or � via � tele � health • Detailed � services? � recommendations � for � PCP CPAA � Pediatrics � Cohort CPAA � Pediatrics � Cohort Northwest � Pediatric � Olympia � Pediatrics South � Sound � Pediatric � Skagit � Pediatrics Center Associates � and � Catholic � 1 � site � in � Olympia 1 � site � in � Mt � Vernon Community � Services 2 � sites � in � Centralia 7 � Pediatricians 7 � Pediatricians 1 � site � in � Olympia 9 � Pediatricians 2 � ARNPs 2 � ARNPs 6 � Pediatricians 5 � ARNPs 0 � BH � staff � (hoping � LICSW � ? � BH � Staff 2 � ARNPs or � Clinical � Psychologist 1 � Clinical � Psychologist MODEL: 1 � LMHCA MODEL: 1 � LMHC MODEL: MODEL: 20 21