integrating recovery, quality of care and pharmacotherapy

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CalMEND A Quality Improvement Project to
Promote Wellness and Recovery for Individuals
with Mental Illness

• integrating recovery, quality of care and
  pharmacotherapy

12/16/2009
Improving Care. Transforming Lives. Together.
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CalMEND A Developmental Project

• Design a care management program for individuals
  with mental illness
• Applicable in all settings of care
• Blueprint to re-design current care settings and
  inform design of new
• Tools and techniques to promote recovery-driven
  practices/ programs
• a quality improvement toolkit.

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Guiding Principals

• Recovery oriented
• Shared decision making
• Person-centered care
• Community Integration
• Culturally competent
• Inclusive of consumer peers and consumer
  operated services
• Supportive of integrated care
• All types of co-occurring conditions

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Informing References

• IOM Quality Chasm, 6 aims
• Disease management principles and program
  elements
• Wagners Chronic Care Model
• Shared-decision making approaches
• Evidence-based practices
• Client and family perspectives

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Chronic Care Model
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Mental Health Care Model
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Designing a Care Model 4 Steps

• Define requirements
• Vision, Mission
• Conceptual framework and descriptive narrative
• Measures
• Create and/or identify operational strategies and
  approaches
• Test, re-test processes
• Implement
• Develop implementation strategies
• Start small
• Plan for spread

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Step 1 Define Requirements

• Vision CalMEND envisions that all individuals
  will receive support that optimizes their
  development and increases their resiliency and
  recovery from mental illness
• Mission to develop and support publicly funded
  mental health services in California that
• are person-centered, safe, effective, efficient,
  timely and equitable
• are supported by friends and community
• promote wellness/recovery
• fully incorporate shared decision-making between
  consumers, family members and providers

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Step 1 Define Requirements

• Conceptual Framework
• Overview flow chart
• Detailed flow chart
• Descriptive Narrative
• Chapters swim lanes
• Descriptions of components of each swim lane,
  optimal service delivery performance
• Philosophies/principles

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Whats Inside??

• Overview/Introduction
• 7 Chapters
• Correspond to swim lanes
• Subsections correspond to elements on process map
• Descriptions of optimal service delivery
  performance

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Whats Missing??

• Your input!!

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Step 1 Define Requirements

• Measures Process and Outcome
• Access
• Partnership and Engagement
• Assessment
• Understanding
• Personal/Service Planning
• Implementation and Evaluation
• Community/Self Reliance
• Data Sources
• Client
• Administrative

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Step 2 Develop and/or Identify Operational
Strategies and Approaches

• Clinical
• Evidence based practices
• Decision aids
• Other clinical protocols
• Data/IT
• Data sharing/access
• Decision support
• EHR/EMR integration

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Step 2 Develop and/or Identify Operational
Strategies and Approaches

• Education
• Materials and supports
• Compendium of resources
• Reimbursement/Infrastructure
• Gap analysis
• Reimbursement guidance
• New reimbursement approaches

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Step 3 Testing

• About Testing
• Pilot projects
• Plan-Do-Study-Act rapid cycles/tests of change
• Supported by measurement
• Testing Underway
• Collaborative PIP (improve use of antipsychotics)
• Clinically Informed Outcomes Measures
• Data Sharing (to promote integrated care)
• State-level PIP re prescribing practices
• Medication Therapy Management (MTM)
• Future Testing Components of Care Model

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Step 4 Implementation

• Finalize Care Model
• Framework
• Narrative
• Operational strategies and approaches
• Develop training and technical assistance
  programs
• Roll-Out
• Strategically phased
• Supported throughout

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Questions?

• www.calmend.org