scholarly journals Developing a local shared care protocol for managing people with psychotic illness in primary care

2003 ◽  
Vol 27 (7) ◽  
pp. 261-266 ◽  
Author(s):  
Helen Snowden ◽  
Sarah Marriott
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Best Practice ◽  
National Level ◽  
Shared Care ◽  
Psychotic Illness ◽  
Clinical Recommendations ◽  
Best Practice Guidelines ◽  
Care Protocol ◽  
National Service Framework

Aims and MethodThe National Service Framework sets standards to improve the treatment of mental health on a national level, and requires the development of localised shared care protocols. We aimed to develop a shared care protocol for use in local National Health Service (NHS) services, based on best practice guidelines and local consensus. A systematic literature search used three databases and the advice of a clinical expert. Articles satisfying the search inclusion criteria were retrieved and appraised. Clinical recommendations from well-designed regional and national documents relevant to all aspects of the management of psychotic illness in primary care were compared and contrasted by a facilitated group involving primary and secondary care clinicians who drafted the final recommendations. A multi-agency steering group guided the work.ResultsTwenty-two articles were retrieved, of which nine reached the criteria for inclusion. The protocol provided a comprehensive range of recommendations regarding detection, assessment, management, referral and shared working with local mental health services.Clinical ImplicationsUsing local clinical consensus to resolve uncertainty about conflicting clinical recommendations from a series of well-designed guidelines was an effective method for adapting clinical guidelines to local circumstances.

scholarly journals Developing a local shared care protocol for managing people with psychotic illness in primary care

2003 ◽  
Vol 27 (07) ◽  
pp. 261-266 ◽  
Author(s):  
Helen Snowden ◽  
Sarah Marriott
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Best Practice ◽  
National Level ◽  
Shared Care ◽  
Psychotic Illness ◽  
Clinical Recommendations ◽  
Best Practice Guidelines ◽  
Care Protocol ◽  
National Service Framework

Aims and Method The National Service Framework sets standards to improve the treatment of mental health on a national level, and requires the development of localised shared care protocols. We aimed to develop a shared care protocol for use in local National Health Service (NHS) services, based on best practice guidelines and local consensus. A systematic literature search used three databases and the advice of a clinical expert. Articles satisfying the search inclusion criteria were retrieved and appraised. Clinical recommendations from well-designed regional and national documents relevant to all aspects of the management of psychotic illness in primary care were compared and contrasted by a facilitated group involving primary and secondary care clinicians who drafted the final recommendations. A multi-agency steering group guided the work. Results Twenty-two articles were retrieved, of which nine reached the criteria for inclusion. The protocol provided a comprehensive range of recommendations regarding detection, assessment, management, referral and shared working with local mental health services. Clinical Implications Using local clinical consensus to resolve uncertainty about conflicting clinical recommendations from a series of well-designed guidelines was an effective method for adapting clinical guidelines to local circumstances.

scholarly journals 53 Implementation of a Developmental Outreach Clinic housed within a Family Health Team - preliminary findings in building a shared care model for children and youth with mental health and developmental disorders

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e22-e22
Author(s):  
Elizabeth Young ◽  
Rachel Goldfarb ◽  
Laurie Green ◽  
Kathleen Hollamby ◽  
Karen Weyman ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Developmental Disorders ◽  
Family Health ◽  
Shared Care ◽  
Care Model ◽  
Roles And Responsibilities ◽  
Shared Care Model ◽  
Family Health Team

Abstract Background At our inner city hospital, we developed a shared care model between family health teams (FHTs), pediatricians and developmental pediatricians to care for children with mental health and developmental disorders. In phase one of our study, 84 FHT members participated in focus groups to inform the development of our clinic. Family physicians described their role as “referral agent”, “long term supporter” and “healthcare coordinator”. They expressed the desire to “learn” and “do more”, but noted barriers to providing care, including limited training, lack of service knowledge, limited communication, and cumbersome access to mental health and dual diagnosis services. Phase One was completed and accepted for publication. Phase Two describes the implementation of our clinic using a mixed methods approach and report preliminary findings. Objectives To evaluate the first two years of implementation of the developmental clinic housed within a family health team (FHT) an obtain feedback from members of the shared care model. Design/Methods Mixed methods were used including chart review of all patients referred to the clinic and semi structured interviews with primary care physicians, pediatricians and developmental pediatricians regarding their roles in managing children with developmental and mental health disorders, as well as use and impact of the developmental clinic. Results A total of 115 charts were reviewed between Feb 2016 and Jan 2018. Of all patients seen, 34% were female 64% male and 2% transgender. Ages ranged from 1-17 years. Eighty-one percent had an existing diagnosis and were referred for re-assessment while 43% received a new diagnosis: ASD (72%), ADHD (11%), GDD (11%), learning disorder (3%), Anxiety (1%), Other (1%). There was an 8% no show rate. Providers endorsed improved communication through use of a shared EMR for documentation and messaging, and improved service knowledge through availability of a pediatric service navigator who also used EMR to document service and funding applications. Longer term follow up, namely the roles and responsibilities of pediatrics vs. developmental pediatrics vs. primary care remained unclear. Conclusion Implementation of the shared care model for this population with primary care is feasible, and does address some stated barriers to care, including improved communication, increased service knowledge, and provision of reassessments. Further areas to develop include clarifying the roles and responsibilities of the different healthcare providers of children with mental health and developmental disorders, and determining what is needed for long-term follow up and transitional care.

Behavioural Interventions in Primary Care: An Implementation Trial

2008 ◽  
Vol 27 (2) ◽  
pp. 179-189 ◽  
Author(s):  
Dan Bilsker ◽  
John Anderson ◽  
Joti Samra ◽  
Elliot Goldner ◽  
David Streiner
Keyword(s):  
Primary Care ◽  
Health Care Providers ◽  
Best Practice ◽  
Management Approach ◽  
Care Providers ◽  
Intervention Delivery ◽  
Effective Strategies ◽  
Best Practice Guidelines ◽  
Risky Alcohol ◽  
Depression Intervention

Developing effective strategies to keep health care providers' practice current with best practice guidelines has proven to be challenging. This trial was conducted to determine the potential for using brief educational sessions to generate significant change in physician delivery of mental health and substance use interventions in primary care. A 1-hour educational session outlining interventions for depression and risky alcohol use was delivered to a sample of 85 family physicians. The interventions used a supported self-management approach and included free patient access to appropriate selfmanagement resources. The study initially evaluated physicians' implementation of these interventions over a 2-month period. Physician uptake of the depression intervention was significantly greater than uptake of the risky-drinking intervention (32% versus 10%). A follow-up at 6-months posttraining (depression intervention only) demonstrated fairly good maintenance of intervention delivery. Implications of these findings are discussed.

scholarly journals Integration between Primary Care and Mental Health Services in Italy: Determinants of Referral and Stepped Care

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Paola Rucci ◽  
Antonella Piazza ◽  
Marco Menchetti ◽  
Domenico Berardi ◽  
Angelo Fioritti ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Urban Area ◽  
Mental Health Center ◽  
Shared Care ◽  
Stepped Care ◽  
Patterns Of Care ◽  
Classification And Regression Tree ◽  
Local Health Authority ◽  
Local Health

This study, carried out in the context of a collaborative care program for common mental disorders, is aimed at identifying the predictors of Primary Care Physician (PCP) referral to Community Mental Health Center (CMHC) and patterns of care. Patients with depression or anxiety disorders who had a first contact with CMHCs between January 1, 2007–December 31, 2009 were extracted from Bologna Local Health Authority database. A classification and regression tree procedure was used to determine which combination of demographic and diagnostic variables best distinguished patients referred by PCPs and to identify predictors of patterns of care (consultation, shared care, and treatment at the CMHC) for patients referred by PCPs. Of the 8570 patients, 57.4% were referred by PCPs. Those less likely to be referred by PCPs were living in the urban area, suffered from depressive disorder, and were young. As to the pattern of care, patients living in the urban area were more likely to receive shared care compared with those living in the nonurban area, while the reverse was true for consultation. Predictors of CMHC treatment were depression and young age. Prospective studies are needed to assess length, quantity, and quality of collaborative treatment for common mental disorder delivered at any step of care.

Interdisciplinary perspectives on the management of the unsettled baby: key strategies for improved outcomes

2012 ◽  
Vol 18 (4) ◽  
pp. 332 ◽  
Author(s):  
Pamela S. Douglas ◽  
Renata E. Mares ◽  
Peter S. Hill
Keyword(s):  
Primary Care ◽  
Health Professionals ◽  
Best Practice ◽  
Professional Communication ◽  
Selection Strategy ◽  
Clinical Expertise ◽  
Extensive Experience ◽  
Best Practice Guidelines ◽  
Early Primary ◽  
Primary Care Practitioners

The objectives of this study were to analyse the perspectives of key informants with clinical expertise in the care of unsettled babies in the first few months of life and their families, concerning changes required to improve outcomes. The research used a purposive selection strategy and thematic analysis of key informant interviews of 24 health professionals from 11 disciplines. Informants were selected for extensive experience in the management of unsettled babies and their families.Participants corroborated existing evidence that post-birth care in Australia is fragmented. All held the view that, first, early primary care intervention for unsettled infants and their families, and second, improved cross-professional communication, are vital if the burden of this problem to the infant, family and health system are to be minimised. There was consensus, third, that significant gaps exist in health professionals’ knowledge base and management behaviours.The development of education resources, best practice guidelines, shared assessment frameworks for primary care practitioners and strategies for improved cross-professional communication are necessary to improve the health outcomes and decrease the burden of this common yet complex post-birth problem.

scholarly journals Impact of the Medicare Chronic Disease Management program on the conduct of Australian dietitians’ private practices

2015 ◽  
Vol 39 (2) ◽  
pp. 183 ◽  
Author(s):  
Sarah Jansen ◽  
Lauren Ball ◽  
Catherine Lowe
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Disease Management ◽  
Practice Guidelines ◽  
Private Practice ◽  
Best Practice ◽  
Chronic Disease Management ◽  
Business Practices ◽  
Best Practice Guidelines ◽  
To Receive

Objective This study explored private practice dietitians’ perceptions of the impact of the Australian Chronic Disease Management (CDM) program on the conduct of their private practice, and the care provided to patients. Methods Twenty-five accredited practising dietitians working in primary care participated in an individual semistructured telephone interview. Interview questions focussed on dietitians’ perceptions of the proportion of patients receiving care through the CDM program, fee structures, adhering to reporting requirements and auditing. Transcript data were thematically analysed using a process of open coding. Results Half of the dietitians (12/25) reported that most of their patients (>75%) received care through the CDM program. Many dietitians (19/25) reported providing identical care to patients using the CDM program and private patients, but most (17/25) described spending substantially longer on administrative tasks for CDM patients. Dietitians experienced pressure from doctors and patients to keep their fees low or to bulk-bill patients using the CDM program. One-third of interviewed dietitians (8/25) expressed concern about the potential to be audited by Medicare. Recommendations to improve the CDM program included increasing the consultation length and subsequent rebate available for dietetic consultations, and increasing the number of consultations to align with dietetic best-practice guidelines. Conclusions The CDM program creates challenges for dietitians working in primary care, including how to sustain the quality of patient-centred care and yet maintain equitable business practices. To ensure the CDM program appropriately assists patients to receive optimal care, further review of the CDM program within the scope of dietetics is required. What is known about the topic? The Australian CDM program is designed to facilitate patients to receive subsidised multidisciplinary care for CDM. Dietetics is the third most utilised allied health profession within the CDM program. What does this paper add? This paper demonstrates that dietitians experience challenges in providing services to patients using the CDM program, including pressure to keep fees down, high administrative load, difficulties accessing clear information on compliance requirements, and face barriers to providing best-practice care to patients with chronic disease. What are the implications for practitioners? Changes to the Australian CDM program are required to help dietitians provide health care in line with best-practice guidelines for CDM, and sustainable business practices.

scholarly journals Emotional abuse and neglect in a clinical setting: challenges for mental health professionals

2021 ◽  
pp. 1-6
Author(s):  
Margaret DeJong ◽  
Simon Wilkinson ◽  
Carmen Apostu ◽  
Danya Glaser
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Emotional Abuse ◽  
Best Practice ◽  
Health Workers ◽  
Mental Health Workers ◽  
Best Practice Guidelines ◽  
Abuse And Neglect ◽  
The Common

Summary This article addresses some of the common uncertainties and dilemmas encountered by both adult and child mental health workers in the course of their clinical practice when dealing with cases of suspected emotional abuse or neglect (EAN) of children. We suggest ways of dealing with these according to current best practice guidelines and our own clinical experience working in the field of child maltreatment.

scholarly journals Mass Violence and Early Mental Health Intervention: A Proposed Application of Best Practice Guidelines to Chemical, Biological, and Radiological Attacks

2004 ◽  
Vol 169 (8) ◽  
pp. 575-579 ◽  
Author(s):  
Elspeth Cameron Ritchie ◽  
Matthew Friedman ◽  
Patricia Watson ◽  
Robert Ursano ◽  
Simon Wessely ◽  
...  
Keyword(s):  
Mental Health ◽  
Practice Guidelines ◽  
Best Practice ◽  
Health Intervention ◽  
Mental Health Intervention ◽  
Mass Violence ◽  
Best Practice Guidelines
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