Perfect Depression Care. M. Justin Coffey, MD Henry Ford Health System IBHI Webinar Series 2011
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1 Perfect Depression Care M. Justin Coffey, MD Henry Ford Health System IBHI Webinar Series 2011
2 M. Justin Coffey, MD Behavioral Health Services Henry Ford Hospitals & Health System
3 Depression Care Team Terri Robertson, PhD Kelli Miller, NP Judy Haefner, NP Wendy Bertgess-Yost, PhD Nancy Sammons, RN M. Justin Coffey, MD Richard Dryer, MD Bill Conway, MD C. Edward Coffey, MD
4 Webinar Objectives Provide a brief history and operations overview of the Perfect Depression Care initiative. Share current work on Perfect Depression Care spread. Answer your questions.
5 Henry Ford Health System
6 Behavioral Health Services 2 hospitals 8 clinics 325 employees $40M GPR Education programs Research programs A system within a system
7 Pursuing Perfect Care In its current form, habits, and environment, the health care system is incapable of giving Americans the health care they want and deserve The current care systems cannot do the job. Trying harder will not work. Changing systems of care will.
8 There Are No Toyotas The current US system produces exactly what it was designed to highly variable care, widespread failures to implement best practices, and inability to change patterns of practice. Molly Joel Coye, Health Affairs, 2001
9 Business as Usual Will Not Work The current system is in shambles a patchwork relic the result of disjointed reforms and policies that cannot be fixed by traditional reform measures.
10 The Institue of Medicine Chasm Report Six Dimensions of Perfect Care Safe Effective Patient centered Timely Efficient Equitable
11 A Roadmap for Health Care Transformation 10 Rules for Perfect Care Care = relationships Care is customized Care is patient centered Share knowledge Manage by fact Make safety a system priority Embrace transparency Anticipate patient needs Continually reduce waste Professionals cooperate
12 The Perfect Depression Care Initiative Goal: Develop a system of perfect care in 2 years Competitive Application Process Coordinated by IHI & RWJ 3000 applications downloaded ~300 applications submitted semifinalists 12 finalists Henry Ford Medical Group: Depression Care and Prostate Cancer Care
13 Perfect, really? Perfect, perfect? If 99.9% quality is good enough, then 2 million records will be lost by IRS 12 babies will be given to wrong parents 18,322 pieces of mail will be mishandled in the next hour 2 landings at Detroit Metro Airport will be unsafe today
14 Why Depression?
15 What Might Perfect Depression Care Look Like?
16 Perfection Defined Safe: Eliminate inpatient falls & medication errors Effective: Eliminate suicides Patient-Centered: 100% of patients will be completely satisfied with their care Timely: 100% complete satisfaction Efficient: 100% complete satisfaction Equitable: 100% complete satisfaction
17 Award Winning Care 2002 RWJ Foundation Pursuing Perfection finalist 2002 HFHS Quality Expo Quality Award 2003 APA Administrative Psychiatry Award 2003 AHRQ Nominee National Best System Practice 2004 ACMHA National Model of Care 2004 AMGA Acclaim Award Honoree 2006 APA Gold Achievement Award 2006 TJC Codman Award 2008 TJC National Model of Excellence 2009 Commonwealth Fund Case Study for Excellence Featured in JAMA May 19, 2010
18 Suicides per 100,000 HMO Patients 250 Suicides per 100, Q3 Expected suicide rate for patients with an active mood disorder (21X) YTD Expected rate for euthymic patients with mood disorder (4-10X) Number of suicides per 100,000 US general population Number of suicides per 100,000 HAP-HFMG patients Number of suicides per 100,000 US general population
19 How d d They Do That?
20 The HFHS Culture of CQI Employee Engagement Focus on the processes! Continuous Improvement & Innovation Customers Needs & Engagement Evaluate the effectiveness of the improvement methods & tools used
21 Strategies for Pursuing Perfection Form a team, and create a name and logo Map our care processes and identify high-leverage OFIs (Planned Care Model) Set specific perfection goals and manage by fact Ensure the voice of the customer in care design (the Consumer Advisory Board) Develop and implement rapid tests of change (PDCA Cycles) Continuous learning Celebrate successes
22 Our Team, Circa 2000 Blues Busters Team Our promise to each and every patient: "We will work with you to achieve the best possible care, always respecting your individual wants and needs."
23 Planned Care Model Community Resources and Policies Health System Health Care Organization Self- Management Support Delivery System Design Decision Support Clinical Information Systems Informed, Activated Patient Productive Interactions Prepared, Proactive Practice Team Improved Outcomes
24 Transformation Intervention
25 Informal Focus Group Hints Depression website probably not Drop-in group visits maybe not Suicide risk assessment tool maybe not CBT certification maybe Treatment algorithms maybe Suicide prevention protocol yes!
26 Suicide Prevention Protocol
27 A Social Intervention Culture shift: Perfect care is the goal. Culture shift: All patients are at increased risk for suicide. Culture shift: Focus on process improvement.
28 Questions?
29 Perfect Care in Real Time I. Report of Patient Status by Patient or Fam ily/significant Other Please Mark Line Emotional Health: Physical Health: Thoughts of Suicide: Thoughts of Hurting Others: Social Functioning: Occupational Functioning: Safety of ECT Care: Sense of Control Over ECT Care: Timeliness of ECT Care: Efficiency of ECT Care: Equity of ECT Care: Overall Satisfaction with ECT Care: bad, lots of problems 0 Please Describe Evidence of Relapse / Signal Events: List 3 things you would like to discuss with your doctor or ECT staff: 50 perfect, no problems 100 Report Given By: Relationship to Patient: Date:
30 Patient Assessment of ECT Care 100 Overall 100 Safety 100 Control % Completely Satisfied % Completely Satisfied BL BL BL % Completely Satisfied Timeliness 100 Efficiency 100 Equity % Completely Satisfied BL % Completely Satisfied BL % Completely Satisfied BL
31 Business Viability of Perfect Care Perfect Care Community Service 100% Service Excellence Research Productivity 0% Employee Engagement Trainee Satisfaction Growth Financial Health
32 Lessons Learned & Next Steps The Chasm Report is a viable model for care Perfection is the goal Involved leadership is key Data are essential manage by fact IT support crucial workflow drives outcomes The science of spread The business case for perfect care The toxic effects of pursuing perfection
33 Questions?
34 PDC Spread Vision: Every patient receives perfect depression care regardless of care setting or general medical comorbidities. All patients with high risk chronic conditions are screened and, if indicated, treated for depression.
35 Family of Depression Care Models HFHS DIAMOND IMPACT 3CM
36 HFHS Model Similar results on a shoestring budget.
37 Staffing Model Nurse Practitioner 50% spread, 50% clinical 2.0 FTE Clinical Psychologist 0.1 FTE Psychiatrist Physician Champion 0.2 FTE Program Manager 1.0 FTE NP resides in a spread site for 2-3 months to assist staff with learning the screening tools and process Available for curb-side consults with physicians or to see patients for urgent consultation Serve as a liaison to inpatient & outpatient BHS
38 Preliminary Results 1 Spread to 7 of 27 clinics in 3 years. Screening rate currently 50%. 22% of persons with chronic disease screened positive for depression. Chronic disease = DM, CAD, CHF, COPD, Asthma, or Chronic Kidney Disease
39 Preliminary Results 2: Only 1% of patients refused to be screened.
40 Preliminary Results 3: PCP s Can Do It! 90% of patients screening positive were managed by their PCP. 67% of patients screening positive received pharmacotherapy from their PCP.
41 Preliminary Results 3: Treatment Works! 53% of patients screening positive achieved a full response to antidepressant treatment. Of the patients with DM who screened positive & received treatment, 65% had a HbA1c reduction of 1.0 (p<0.05).
42 How does the HFHS model work? HFHS DIAMOND IMPACT 3CM
43 Keys to Success 1. Embed a behavioral health clinician. 2. Use the model for improvement & focus on the processes. 3. Empower the front line staff to design the care processes. 4. Use simple, efficient tools. 5. Don t be afraid of the s word suicide. 6. Deliver regular performance feedback to front line team members. 7. Recruit & empower effective change agents. 8. Obtain & maintain leadership support. IMPLEMENT SUSTAIN
44 Key 5: Don t be afraid of the s word suicide.
45 Suicide Can Be Deadly The suicidal patient is a major source of anxiety for primary care teams. Anxiety can lead to process breakdown. Without a clear process in place for managing the suicidal patient, depression care is dead in the water.
46 One Possible Solution?
47 An Alternative Solution The assessment & management of the suicidal patient in primary care settings demands systems work focusing on process improvement.
48 Spreading to Primary Care Our PHQ-9 is the called DST. Positive screen to any of the above questions, prompts a same day psychiatric evaluation.
49 Keys to Success 1. Embed a behavioral health clinician. 2. Use the model for improvement & focus on the processes. 3. Empower the front line staff to design the care processes. 4. Use simple, efficient tools. 5. Don t be afraid of the s word suicide. 6. Deliver regular performance feedback to front line team members. 7. Recruit & empower effective change agents. 8. Obtain & maintain leadership support. IMPLEMENT SUSTAIN
50 Take Home Theme Although suicide is a statistically very rare event, even within psychiatric populations, improvement efforts focused on the processes of care in which patients and clinicians live and work can drive successful clinical quality improvement work.
51 Thank You
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