CE for CCM & CDMS Approved for 2 hours of CCM, CDMS and nursing education credit
Exclusively for ACCM Members
An integrated whole-person recovery model and multidirectional practice of communication must become the standard in clinical care integration to ensure quality outcomes for patients. 9. Use of technology to maximize time and communications remains essential. Virtual staffings are possible, although the throwback to in-person team rounds has ensued. Fewer cases can be reviewed with the latter. 10. Continued evolution in care coordination means that multidirectional communication between the medical and behavioral health teams must exist, expand, and become a monitored industry standard. 11. Behavioral health can become a dumping ground for those high-need, resource-using patients with many physical complaints that are not easily explained. Multidirectional care coordination can reduce this possibility. 12. Complex care patients without behavioral health diagnoses/symptoms do not automatically have a need for behavioral health services. Rule out normal responses to certain situations that should not be pathologized. 13. P atient physical complaints should be accepted and taken seriously and integrated into the medical and/or behavioral health care plans. 14. I nvolve patients in team discussions and the care plan. 15. Practitioners and providers should develop increased sensitivity to patients with substance abuse diagnoses. 16. Consider that patients who do not adhere to medical regimens do not de facto have a mental health diagnosis. 17. M aintain a mindful and self-aware approach to facilitate helpful treatment alliance and the likelihood of patient adherence to treatment plans. Patients with behavioral health comorbidity may be tiring, frustrating, and draining to the professional team. This can negatively impact compassion, listening, and a clear clinical approach. 18. Patient recovery practices promote the best multidirectional communication between care coordinators, the treating team, and the patient. 19. Multidirectional care coordination is a holistic model that must grow in the field. Each provider on the team as well as the patient must work to communicate, share data, plan, and review. Although the care coordinator may take the lead, all must be invested and responsive. Use of technology for efficient communications remains key. Time- consuming phone tag should be avoided at all costs. 20. The ACE studies are 20 years old. The time to 18 CareManagement June/July 2017
incorporate education, insight, and human rights, coupled with policies and practices for prevention of ACEs, into the entire health care field is overdue. Behavioral health providers should make assessment of ACEs standard practice and relay these scores to the medical team/PCP. 21. C ontinuous education and use of the following three tools provide a framework for effective implementation of the integrated person-centered recovery care coordination model: motivational interviewing, recovery language, and cultural competency. 22. The ACE studies demonstrate the impact of trauma and violence on health and wellness. The treating team must work with the patient to ensure safety and nonviolence, without which optimal health should not be expected. CE II
References 1. Gomez MY. URAC Best Practice Award Winner: Mental Health–PCP Coordination of Care: Medical Follow-Up After Behavioral Health Admission. 2011. 2. PsycHealth, Ltd. Team communication, March 2017. www.psychealthltd.com. 3. National Committee for Quality Assurance 2017. http://www.ncqa.org/. 4. Centers for Disease Control and Prevention 2016. Adverse Childhood Experiences (ACEs). https://www.cdc.gov/violenceprevention/acestudy/. Accessed April 7, 2017. 5. Anda RF, Felitti VJ, Bremner JD, et al. The enduring effects of abuse and related adverse experiences in childhood: a convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiatry Clin Neurosci. 2006; 256(3):174-186. 6. Afifi TO, Ford D, Gershoff, E, et al. Spanking and adult mental health impairment: the case for the designation of spanking as an adverse childhood experience. Child Abuse & Neglect; 2017. http:// dx.doi.org/10.1016/j.chiabu.2017.01.014. 7. Henderson C, Noblett J, Parke H, et al. Mental health-related stigma in health care and mental health-care settings. Lancet Psychiatry. 2014;1(6):467-482. 8. Substance Abuse and Mental Health Services Administration. Recovery and Support. http://www.samhsa.gov/recovery. (n.d.) Accessed December 8, 2015. 9. Congressional Study. (n.d.). The Mental Health Parity Act—A
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