Bridging community mental health and primary care to improve medication monitoring and outcomes for patients with mental illness taking second-generation antipsychotics-HDC/DFMC bridge project, phase 1: Group concept mapping

Keri Hager, Margarette Kading, O’Donnella Carolyn, Ann Yapel, Danielle MacDonald, Jennifer Nelson Albee, Cynthia Nash, Colleen Renier, Katherine Dean, Mark Schneiderhan

Research output: Contribution to journalArticle

Abstract

Objective: Patients with severe mental illness often lack care coordination between primary care and mental health providers. Siloed patient care across separate health care systems can negatively impact quality and safety of patient care. The purpose of the project discussed in this article is to effectively engage stakeholders from separate primary care and mental health organizations to develop an ideal cross-organization communication system to improve metabolic monitoring for their comanaged patients prescribed second-generation antipsychotics (SGAs). Methods: The mixed method approach of group concept mapping was used to engage stakeholders across a nonaffiliated primary care clinic and a community mental health organization over the time period of March 2018 through May 2018. Results: Three important domains in communication were identified: (1) process/workflow, (2) advocacy, and (3) a patient-centered focus. Seven high priority/easier to implement brainstormed items were identified and resulted in practice changes across both organizations, including developing a standard release of information, identifying a point person from each clinic focused on cross-organization care coordination, endorsing an SGA monitoring protocol across organizations, agreeing that metabolic monitoring of SGAs will be the responsibility of the primary care clinicians, beginning monthly medication reconciliation and cross-organization care conferences, developing standard electronic health record documentation, and providing education. Conclusions: Care coordination across all health systems is critical to optimize patient care for chronic medical and psychiatric conditions. Group concept mapping provides a strategic process to allow shared decision-making among stakeholders to take steps toward solving more complex systematic problems such as poor electronic health record interoperability across health systems.

Original languageEnglish (US)
Article number19m02452
JournalPrimary Care Companion to the Journal of Clinical Psychiatry
Volume21
Issue number4
DOIs
StatePublished - Jan 1 2019

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Community Health Services
Mentally Ill Persons
Physiologic Monitoring
Antipsychotic Agents
Primary Health Care
Mental Health
Organizations
Patient Care
Electronic Health Records
Medication Reconciliation
Communication
Workflow
Health
Ataxia
Documentation
Psychiatry
Decision Making
Delivery of Health Care
Safety
Education

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Bridging community mental health and primary care to improve medication monitoring and outcomes for patients with mental illness taking second-generation antipsychotics-HDC/DFMC bridge project, phase 1 : Group concept mapping. / Hager, Keri; Kading, Margarette; Carolyn, O’Donnella; Yapel, Ann; MacDonald, Danielle; Albee, Jennifer Nelson; Nash, Cynthia; Renier, Colleen; Dean, Katherine; Schneiderhan, Mark.

In: Primary Care Companion to the Journal of Clinical Psychiatry, Vol. 21, No. 4, 19m02452, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "Objective: Patients with severe mental illness often lack care coordination between primary care and mental health providers. Siloed patient care across separate health care systems can negatively impact quality and safety of patient care. The purpose of the project discussed in this article is to effectively engage stakeholders from separate primary care and mental health organizations to develop an ideal cross-organization communication system to improve metabolic monitoring for their comanaged patients prescribed second-generation antipsychotics (SGAs). Methods: The mixed method approach of group concept mapping was used to engage stakeholders across a nonaffiliated primary care clinic and a community mental health organization over the time period of March 2018 through May 2018. Results: Three important domains in communication were identified: (1) process/workflow, (2) advocacy, and (3) a patient-centered focus. Seven high priority/easier to implement brainstormed items were identified and resulted in practice changes across both organizations, including developing a standard release of information, identifying a point person from each clinic focused on cross-organization care coordination, endorsing an SGA monitoring protocol across organizations, agreeing that metabolic monitoring of SGAs will be the responsibility of the primary care clinicians, beginning monthly medication reconciliation and cross-organization care conferences, developing standard electronic health record documentation, and providing education. Conclusions: Care coordination across all health systems is critical to optimize patient care for chronic medical and psychiatric conditions. Group concept mapping provides a strategic process to allow shared decision-making among stakeholders to take steps toward solving more complex systematic problems such as poor electronic health record interoperability across health systems.",
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