Welcome to the fourth edition of the CFHA News and Research
Column, a new series of posts that highlight recent developments in the field
of collaborative and integrated care. Check back for additional reports.
NEWS
Texas
Lawmakers Focus on Integrated Care
The state of
Texas is in a state of mental health crisis. Part of the problem is a shortage
of mental health professionals. The
Select Committee on Mental Healthwas specifically createdto
tackle the issue. In June, the committee — headed by Rep.Four Price,
R-Amarillo— met to discuss on how the state wants to take a holistic
approach regarding mental health treatment. The committee heard from experts on
insurance and criminal justice mental health professionals including Dr.
William Lawson at Dell Medical School. His goal is to get more minority mental
health providers into the underserved areas of Texas.He says integrated
care is key.
“We now know
that early intervention can actually change the trajectory of what happens with
folks who develop a mental disorder,” said Dr. Lawson.
Family-Oriented
Program in England Partners Nurses with Patients
The Family
Integrated Care program, at St. James’ Hospital in Leeds, England, empowers
parents to take control of their baby’s care by being given the skills to
become more involved and build confidence. Parents are coached by nurses on feeding
and changing as well as taking regular observations and giving medication. Rates
of breastfeeding at discharge from hospital have doubled to nearly 60 per cent
and the length of stay has been reduced by up to nine days in babies born up to
10 weeks early. Infections and complications also seem improved.
Collaborative Care in Various Special Populations
·
Pharmacy:
New push for more pharmacy collaborative care
·
Patients
with disabilities: Occupational therapists collaborating with other
services
·
Substance
Use, Serious Mental Illness: call for more integrated services
·
Women’s
Health: International group calls for stronger integration of services to
improve health outcomes among adolescent girls and young women
·
Dental
Care: Oral health screening for kids in Colorado medical office
Integrated
Care is Not Sustainable
The latest NHS Financial
Temperature Check survey out of England of more than 200 finance directors shows
that just 16% were ‘very or quite confident’ that their organization could
deliver a sustainable integrated care service for the period up to March 2021. Paul
Briddock, director of policy at HFMA, said: “The scale of the NHS deficit
continues to reach unparalleled levels, and it is unlikely the provider
position will be in balance at the end of 2016-17, as originally planned.
“Our report confirms that while
finance directors are feeling the pressures of the current financial situation,
many also feel like short-term gains such as cash injections and non-recurrent
savings are merely storing up more problems for the future.”
Mobile
Clinics Could Revolutionize Health Care
A senior Annapolis doctor says
that just four mobile clinics could revolutionize healthcare for rural Nova
Scotians — and they will come cheap.
Dr. Ken Buchholz, a former senior
physician advisor with the Department of Health, estimated that four
fully-equipped trailers plus their support vehicles would cost just over $1
million. This is the same average price tag as a single bricks-and-mortar
collaborative care clinic that the government plans to roll out across the
province.
“Nova Scotia was once a leader in
the country with this mobile health model, but it fell victim to fiscal
restraint and a lack of vision by health department officials. Perhaps it is
time to revisit the notion of mobile healthcare, but this time with an open
mind and a more positive approach,” said Buchholz.
RESEARCH
·
Meta-analysis of
collaborative care for anxiety: Collaborative care seems to be a promising
strategy for improving primary care for anxiety disorders, in particular panic
disorder. However, the number of studies is still small and further research is
needed to evaluate the effectiveness in other anxiety disorders.
·
Checklist for family
meetings: Researchers
developed the Family Meeting Behavioral Skills
Checklist (FMBSC) to measure advanced communication skills of fellows in family
meetings of critically-ill patients based on a literature review and consensus
of an interdisciplinary group of communications experts. The FMBSC demonstrated internally consistency and
structural validity in assessing advanced communication skills.
·
Collaborative care in
Nigeria: It is feasible to scale up mental health services in primary care
settings in Nigeria, using the WHO Mental Health Gap Action Programme
Intervention Guide and a well-supervised cascade-training model. This format of
training is pragmatic, cost-effective and holds promise, especially in settings
where there are few specialists.
·
Collaborative Care in
HCV Clinics: Depression collaborative care resulted in modest improvements in
HCV patient depression outcomes. Future research should investigate
intervention modifications to improve outcomes in specialty hepatitis C virus
treatment clinics.
