|
 |
- An Intervention to Promote Evidence-Based Prescribing at a Large Psychiatric Hospital (Psychiatric Services, March 2009)
An intervention to affect prescribing behavior was implemented at a large psychiatric hospital. Articles providing support for appropriate dosing of quetiapine were distributed to physicians, and peer discussions about prescribing practices were held. From April 2005 through December 2006, low-dose quetiapine prescriptions ({less/equal}200 mg per day) were flagged. For four months, physicians writing lowdose prescriptions received personal feedback from the unit medical director, who encouraged appropriate alternatives. New low-dose prescriptions fell from 107 in July 2005 to 23 in December 2006. Monthly costs for quetiapine prescriptions declined by approximately $8,000. The intervention appeared to bring physicians' behavior more in line with evidence-based practices.
- Recommendations for the Framework and and Format of Healthy People 2020: Phase 1 Report (10/28/08)
Each decade since 1980, the US Department of Health and Human Services (HHS)has released a comprehensive set of national public health objectives. Known as Healthy People, the initiative has been grounded in the notion that setting objectives and providing benchmarks to track and monitor progress can motivate, guide, and focus action. This year, HHS began developing the next decade's objectives, Healthy People 2020. HHS convened the Secretary's Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2020 to aid in this process. The Advisory Committee was charged with providing advice and consultation to the secretary: 1) to facilitate the development and implementation of national health promotion and disease prevention goals and objectives, and 2) to inform the development of initiatives that will occur during initial implementation of the goals and objectives. During the first phase of its work (January - October 2008), the Advisory Committee has produced recommendations for the Healthy People 2020 form, framework, and guidelines for implementation. The recommendations are summarized in this report. In 2001 ACMHA convened its Summit and examined the relevance for behavioral health care of the Institute of Medicine's Crossing the Quality Chasm report. Over 90 leaders in the behavioral health care field agreed that the report provided a compelling argument for the need to reform the American health care system in general, and more specifically behavioral healthcare. There was consensus that the IOM framework could serve as an effective tool for strategic redirection of the field. This monograph builds upon the work of the Summit with additional input from a work group convened by SAMHSA and ACMHA in May 2003. That group provided additional review of the Quality Chasm report, The President's New Freedom Commission and other initiatives. There are important and complimentary links between them that together create a roadmap for systems change. This report provides an overview and summary of these efforts and a summary of strategic initiatives for policy reform, service improvement, and quality behavioral healthcare.
- Turning Knowledge Into Practice: A Manual for Behavioral Health Administrators and Practitioners About Understanding and Implementing Evidence-Based Practices (Fall 2003)
The sponsors and the authors of this manual believe in improving the care that people with mental and addictive disorders receive, and we share a belief in the promise of evidence-based practices. But we also know the limitations and realities of translating scientific research findings into the real world of service delivery. So this manual has been developed in large measure to provide a practical approach to moving the field forward. It is written with specific audiences in mind, clinicians and administrators in provider organizations and their chief partners - primary consumers and family members.
This paper was originally conceived during the March 2001 ACMHA Summit on Financing for Results. That Summit explored the issues surrounding financing of behavioral health services in the public sector, specifically within the specialty behavioral health arena. The Summit was held prior to the events of 9/11/01 and prior to the economic recession that has engulfed the US and that has resulted in 47 of 50 states facing severe economic crises as of the final writing of this paper. The Summit and the majority of the writing on this paper also occurred prior to the implementation of the President's New Freedom Commission on Mental Health that has begun to highlight the fragmentation of financing streams for public and private behavioral healthcare.These changes and conditions have profoundly affected our nation and the financing of behavioral health in this country. In addition to affecting the priorities and the amount of funds available, these conditions have raised significant questions about the isolation of behavioral health as a specialty system and have caused behavioral health care leaders to begin considering how leadership in behavioral healthcare finance will have to change to meet the times. These changes will of necessity require that behavioral healthcare leaders understand how public and private financing mechanisms interact and how behavioral healthcare leadership will have to span multiple systems and financing streams now more than ever. Other systems such as child welfare,corrections, juvenile justice, Medicare, Medicaid and public schools are increasingly funding and providing behavioral healthcare for the same people as those served in the behavioral healthcare specialty arena - and more.
The Annapolis Coalition on Behavioral Health Workforce Education resulted from growing national concern about the relevance and effectiveness of efforts to train providers of mental health and addiction services. The Coalition was founded to address four fundamental problems: (1) students completing graduate programs and residency training programs are not adequately trained to practice in the current healthcare environment; (2) practicing rofessionals receive neither effective continuing ducation nor the skills to employ emerging evidence-based models of practice; (3) bachelor degreed and paraprofessional direct care providers are given minimal training in clinical interventions, even though they may have the most contact with people suffering serious disabilities; and (4) consumers and family members are seldom offered training despite the enormous role that they play as primary caregivers. The Coalition released a detailed analysis of these problems and comprehensive set of recommendations for reform. These were published in 2002 as a special double issue of the journal Administration and Policy in Mental Health, Behavioral Health Workforce Education and Training (Volume 29,Number 4/5, May, 2002).
This is an interim report which summarizes the work-to-date in a nearly four ear effort on the part of the American College of Mental Health Administration nd five of the national accreditation organizations in mental health and ubstance abuse services. Working together as the ACMHA Accreditation rganization Workgroup they have attempted to reach agreement on a set ofindicators and measures for the field. The five participating accreditation rganizations include: CARF...The Rehabilitation Accreditation Commission; The Council on Accreditation for Children and Family Services; The Council on Quality and Leadership in Support of Persons with Disabilities; The Joint Commission on Accreditation of Healthcare Organizations; and The National Committee for Quality Assurance. Substantial progress has been made by these organizations in reaching agreement on a framework and hierarchy for considering quality measurement, a common taxonomy, and a set of criteria or desirable attributes to guide decisions about the inclusion of specific indicators in any easurement set. The desirable attributes fall into three categories: mportance of topic area addressed by the measure, usefulness in improving individual outcomes, and measure design.
For additional best practices in behavioral health delivery please see the Network of Care web site, which has a section which is the repository for best practices recognized by NASMHPD: www.networkofcare.org.
|
| |
 |
|
