Continuity of Care / SPOE October 24, 2006. Arthur Ashe What is the secret to becoming a Great...

Continuity of Care / SPOEContinuity of Care / SPOEOctober 24, 2006October 24, 2006

Arthur AsheArthur Ashe

What is the secret to becoming a What is the secret to becoming a Great Tennis Player ?Great Tennis Player ? Start where you are.Start where you are. Use what you have.Use what you have. Do what you can.Do what you can.

CMHCER

Acute Unit

Case Management

Respite

Mobile Assessment

Housing

EmploymentAssistance

FinancialAssistance

Home / Community Based Treatment

Drop In Center

EducationalServices

Assertive Community Treatment

Earlier commentsEarlier comments

Common PurposeCommon Purpose Give and TakeGive and Take Bending and AdpatingBending and Adpating More CoordinationMore Coordination We are all share responsibility for We are all share responsibility for

persons with Psychiatric issues in ER’s persons with Psychiatric issues in ER’s despite structural / organizational despite structural / organizational barriersbarriers

Improve the hand offImprove the hand off

OMH Continuity of Care PolicyOMH Continuity of Care Policy

http://http://

www.laomh.org/ContinuityofCare/index.htmwww.laomh.org/ContinuityofCare/index.htm

Continuity of CareContinuity of Care Informational ContinuityInformational Continuity – Information is the common thread linking – Information is the common thread linking

care from one provider to another and from one healthcare event to care from one provider to another and from one healthcare event to another. Information can be disease focused or person focused. another. Information can be disease focused or person focused. Documented information tends to be on the medical condition, but Documented information tends to be on the medical condition, but knowledge about the patient’s preferences, values, and context is knowledge about the patient’s preferences, values, and context is equally important for bridging separate care events and ensuring that equally important for bridging separate care events and ensuring that services are responsive to needs.services are responsive to needs.

Management ContinuityManagement Continuity – is especially important in chronic or – is especially important in chronic or complex clinical diseases that require management from several complex clinical diseases that require management from several providers who could potentially work at cross purposes. Continuity is providers who could potentially work at cross purposes. Continuity is achieved when services are delivered in a complementary and timely achieved when services are delivered in a complementary and timely manner. Shared management plans or care protocols facilitate manner. Shared management plans or care protocols facilitate management continuity, providing a sense of predictability and management continuity, providing a sense of predictability and security in future care for both consumers and providers. In mental security in future care for both consumers and providers. In mental health care, continuity of contact (expressed as access) embodies the health care, continuity of contact (expressed as access) embodies the notion that regular contact is needed to ensure management goals are notion that regular contact is needed to ensure management goals are adapted and met and that providers must often facilitate access to a adapted and met and that providers must often facilitate access to a broad range of services. Flexibility in adapting care to changes in an broad range of services. Flexibility in adapting care to changes in an individual’s needs and circumstances is an important aspect of individual’s needs and circumstances is an important aspect of management continuity. When care is long term, both consistency and management continuity. When care is long term, both consistency and flexibility are critical for management continuity.flexibility are critical for management continuity.

Continuity of CareContinuity of Care Relational ContinuityRelational Continuity – bridges not only past to current care but – bridges not only past to current care but

also provides a link to future care. This is most valued in primary also provides a link to future care. This is most valued in primary and mental health care. Even in contexts where there is little and mental health care. Even in contexts where there is little expectation of establishing ongoing relationships with multiple expectation of establishing ongoing relationships with multiple care givers, a consistent core of staff provides patients with a care givers, a consistent core of staff provides patients with a sense of predictability and coherence.sense of predictability and coherence.

Continuity of CareContinuity of Care is achieved by bridging discrete elements in is achieved by bridging discrete elements in the care pathway – whether different episodes, interventions by the care pathway – whether different episodes, interventions by different providers, or changes in illness status – as well as by different providers, or changes in illness status – as well as by supporting aspects that endure intrinsically over time, such as supporting aspects that endure intrinsically over time, such as consumer’s values, sustained relationships, and care plans. consumer’s values, sustained relationships, and care plans. Processes designed to improve continuity do not Processes designed to improve continuity do not themselves equate to continuity. For continuity to exist, themselves equate to continuity. For continuity to exist, care must be experienced as connected and coherentcare must be experienced as connected and coherent..

For consumers and their families, the experience of continuity is For consumers and their families, the experience of continuity is the perception that providers know what has happened before, the perception that providers know what has happened before, that different providers agree on a management plan, and that a that different providers agree on a management plan, and that a provider who knows them will care for them in the future.provider who knows them will care for them in the future.

The significant role of SPOE is the management and The significant role of SPOE is the management and integration of inpatient services within the array of integration of inpatient services within the array of community service alternatives. As such, it provides a community service alternatives. As such, it provides a geographic and administrative focus for service geographic and administrative focus for service determination and appropriate utilization of resources. determination and appropriate utilization of resources.

The SPOE is in the community, accessible 24 hours a The SPOE is in the community, accessible 24 hours a day and seven days a week. Its role is to provide for day and seven days a week. Its role is to provide for prompt review of screenings, evaluations and prompt review of screenings, evaluations and assessments provided by multiple referral sources assessments provided by multiple referral sources including private providers, Community Mental Health including private providers, Community Mental Health Centers and public agencies. Centers and public agencies.

The SPOE Coordinator will screen and provide The SPOE Coordinator will screen and provide referrals for admission to the OMH Distinct Part referrals for admission to the OMH Distinct Part Psychiatric Beds and the OMH free-standing inpatient Psychiatric Beds and the OMH free-standing inpatient facilities.facilities.

SPOE CoordinatorsSPOE Coordinators

Single Point of EntrySingle Point of Entry Reg. 3 Pam MarcelReg. 3 Pam Marcel Reg. 4 Adofo HarmonReg. 4 Adofo Harmon Reg. 5 Jenny Mills / Jaquita JordanReg. 5 Jenny Mills / Jaquita Jordan Reg. 6 Bart LilesReg. 6 Bart Liles Reg. 7 Amy CreelReg. 7 Amy Creel Reg. 8 Suzanne HatcherReg. 8 Suzanne Hatcher MHSD Tom ElliottMHSD Tom Elliott CAHSD Janet RoyCAHSD Janet Roy FPHSA Sherry SiglerFPHSA Sherry Sigler JPHSA Julie BurkeJPHSA Julie Burke

CMHCER

Acute Unit

Case Management

Respite

Mobile Assessment

Housing


FinancialAssistance


Drop In Center

EducationalServices


19%CMHC / SPOEER

Acute Unit

Case Management

Respite

Mobile Assessment

Housing


FinancialAssistance


Drop In Center

EducationalServices


19%CMHC / SPOEER

Acute Unit

Case Management

Respite

Mobile Assessment

Housing


FinancialAssistance


Drop In Center

EducationalServices


16%Private Facility

19%CMHC / SPOEER

Acute Unit

Case Management

Respite

Mobile Assessment

Housing


FinancialAssistance


Drop In Center

EducationalServices


16%

11%

Private Facility

19%CMHC / SPOEER

Acute Unit

Case Management

Respite

Mobile Assessment

Housing


FinancialAssistance


Drop In Center

EducationalServices


16%

11%

Private Facility

IntermediateCare Hospital

11%

SPOESPOE (*based on 2005 survey) (*based on 2005 survey)

19% CMHC to Acute Unit19% CMHC to Acute Unit 16% Private Facility to Acute Unit16% Private Facility to Acute Unit 11% CMHC to Private Facility11% CMHC to Private Facility 11% Private Facility to Intermediate 11% Private Facility to Intermediate

HospitalHospital 9% Private referral to CMHC9% Private referral to CMHC 9% Hospital to CMHC9% Hospital to CMHC 7% CMHC to Intermediate Hospital7% CMHC to Intermediate Hospital 18% Other18% Other

SPOESPOE

HANDOUTSHANDOUTS What you need to provide to the SPOE What you need to provide to the SPOE

when calling with a referral ?when calling with a referral ? What can you expect the SPOE to do ?What can you expect the SPOE to do ? What will the SPOE do if no beds are What will the SPOE do if no beds are

available within the OMH system ?available within the OMH system ? Who to call if there are problems or Who to call if there are problems or

concerns ?concerns ?

SPOESPOE Problem solving processProblem solving process

Many SPOE issues can best be resolved at the Many SPOE issues can best be resolved at the local levellocal level

Handouts indicate who to call if there are issues Handouts indicate who to call if there are issues to be worked out if working with the SPOE has to be worked out if working with the SPOE has not proven successfulnot proven successful

Problem resolution should follow a progressive Problem resolution should follow a progressive process moving up the chain of authority only process moving up the chain of authority only as attempts at the local, regional, levels are as attempts at the local, regional, levels are unsuccessful in order to ensure that there is unsuccessful in order to ensure that there is local ownership or responsibility, continuity of local ownership or responsibility, continuity of information, communication of concerns, information, communication of concerns, efficient use of limited resources, timely local efficient use of limited resources, timely local solutions and empowerment of local decision solutions and empowerment of local decision makers.makers.

CMHCER

Acute Unit

Case Management

Respite

Mobile Assessment

Housing


FinancialAssistance


Drop In Center

EducationalServices


Earlier SPOE Comments / QuestionsEarlier SPOE Comments / Questions

Cross regional coordinationCross regional coordination Common standards across regionsCommon standards across regions Individuals referred to ER at 4:30 pmIndividuals referred to ER at 4:30 pm Issues with Private Hospitals – Issues with Private Hospitals –

relationships, communication, relationships, communication, procedures / protocols.procedures / protocols.

To Be Continued...To Be Continued...Continuous engagement in treatment and Continuous engagement in treatment and recovery services is one of the most important aspects of recovery services is one of the most important aspects of addressing acute episodes of severe behavioral health problems addressing acute episodes of severe behavioral health problems and the ongoing disabilities associated with them.and the ongoing disabilities associated with them.

Processes designed to improve continuity do not themselves Processes designed to improve continuity do not themselves equate to continuity. equate to continuity.

For consumers and their families, the experience of continuity is For consumers and their families, the experience of continuity is the perception that providers know what has happened before, that the perception that providers know what has happened before, that different providers agree on a management plan, and that a different providers agree on a management plan, and that a provider who knows them will care for them in the future.provider who knows them will care for them in the future.

Please work with and through your SPOE and Administrative Please work with and through your SPOE and Administrative structure to resolve issues locally when at all possible.structure to resolve issues locally when at all possible.

Continuity of Care / SPOE October 24, 2006. Arthur Ashe What is the secret to becoming a Great...

Documents

Transcript of Continuity of Care / SPOE October 24, 2006. Arthur Ashe What is the secret to becoming a Great...