Interprofessional Education: Transforming Care through Teamwork - Daniel Rivas
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Daniel Rivas, MD, Family Medicine Physician, Sea Mar Community Health Centers
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Interprofessional Education: Transforming Care through Teamwork - Daniel Rivas
- 1. Interprofessional Education: Transforming Care Through Teamwork Daniel Rivas, MD Sea Mar Community Health Centers Burien, WA
- 2. Outline • Mental Health Integration Programs – MCBH – Integration Specialist • Maternity Support Programs – ICM/MSS/WIC – High Risk OB meetings • Patient-Centered Medical Home Model • Benefits of Integration • Challenges
- 3. Mental Health Integration Programs • Integration Specialist • Maternal Child Behavioral Health
- 4. MHIP Team • Patient • PCP • Care Coordinator/Grou p Facilitator • Therapist • Consulting Psychiatrist
- 5. Mental Health Integration PCP Patient Care Coordinator and Therapist Consulting Psychiatrist Primary Care (Sea Mar Community Health Center)
- 6. MCBH • Screening • Education • Support
- 7. Maternity Programs • Maternity Support Services – RN – Social Worker – Infant Case Managers – Doula (AmeriCorps) • WIC • High Risk OB Meetings
- 8. High Risk OB Meetings • OB Providers • OB Coordinators / Community Health Workers • Maternity Support Services RN • Social Worker • Maternal Child Behavioral Health • Doula • Infant Case Managers
- 9. Patient-Centered Medical Home • Team Approach – Care Coordinator – Medical Assistant – Integration Specialist – Healthcare Provider • Group Huddle • Shared Workspace
- 12. Benefits of Integration • Proximity • Team Approach • Multidisciplinary • Collaboration • Coordination • Improved Patient Outcomes
- 13. Challenges • Physical Space • Cost • Training • Time • Information Sharing
- 14. Thank You Email: DanielRivas@seamarchc.org Images (free license): www.freeimages.com www.morguefile.com
Editor's Notes
- MCBH Integration Specialist (formerly Mental & Behavioral Health Coordinator)
- Mental Health Integration Program Team
- Teamwork Coordination Group and Individual counseling Psychiatric expertise in developing a plan and troubleshooting Integration Specialist – sees uninsured patients up to 6 times, insured patients once then referred. Small amount of “regular patients” before caseload changed. Can hospitalize patients who are homicidal, suicidal, severely depressed patients. Reviews PHQ9/GAD7. Sorts out things prior to physician seeing it.
- Implement screening of mothers and children in both maternity support programs and in primary care centers. Educate women about maternal depression Increase availability of peer support for women who are at risk of or are experiencing depression and other mood disorders.: Options discussed: support group, individual counseling or immediate crisis intervention and follow up or outside referral. Consultation with psychiatrist Referrals from: Maternity Support Services Public Health Department Primary Care Provider Grant to 2017 Sarah Doty is therapist, Lisa is supervisory role has experience as therapist.
- Physical Proximity, same building. Stories of MSS coming across to clinic and vice versa ICM- criteria more selective, after birth
- Health Home has changed our thinking Inspired us to make changes in our clinic and how we think about our work and flow “The PCMH is a model of primary care in which a team of clinicians offers accessible first-contact care that is personal, coordinated and comprehensive and meets most or all of a person’s health care needs, including behavioral health.” American Academy of Family Physicians, 2014. Currently recognized by NCQA (national committee for quality assurance) as PCMH level 2 and are working on level 3 recognition. Tell Story of Foot and foot doctor. Shared workspace – compare with and without shared workspace
- Patient comes to clinic to see care team, not just the provider. Screened by the MA, which triggers depression quesionnaire to be filled out and pt meet with the Integration specialist to further screen and coordinate MH f/u, then seen by Coordinator who can troubleshoot why pt hasn’t been taking their medications, or logging their glucoses, who triggers the Health ed for more diabetes education. All before seeing the provider.
- Restructuring to achieve goals.
- “One stop shop” convenience to patients, Walk across the courtyard in real time. Experience with MCBH in other clinics. Collaboration Communication Education
- Traditional provider rooms small, made for 1-2 providers, but were stretched to fit 3. changed furniture to fit 5 people. Cost of programs, rearranging, remodeling, Training of staff – extent of their license /abilities. Hard to train new ways of doing things. Steep learning curve while implementing / testing new duties. Time – new expectations, but work flow does not allow for it Integration of Electronic Health Records – MCBH uses UW health records – improving but has a lot of work to go.