Psychiatry

The Integrated Behavioral Health Continuum: Theory and by Dr Laurel J Kiser Ph.D., Dr Paul M Lefkovitz Ph.D., Dr

Posted On March 23, 2017 at 6:04 pm by / Comments Off on The Integrated Behavioral Health Continuum: Theory and by Dr Laurel J Kiser Ph.D., Dr Paul M Lefkovitz Ph.D., Dr

By Dr Laurel J Kiser Ph.D., Dr Paul M Lefkovitz Ph.D., Dr Lawrence L Kennedy M.D.

Until eventually lately, behavioral healthiness was once outlined in the strict dichotomy of inpatient and outpatient careAa dichotomy that didn't reflect the variety and complexity of human adventure and scientific wishes. TodayAs built-in procedure renders this dichotomy out of date. in its place, provider supply integration techniques supply an equipped process of care rooted in a typical imaginative and prescient and outlined through techniques meant to advertise continuity and caliber of care, coordination of efforts, efficiencies of operation, and seamless sufferer flow via an differently bewildering array of overall healthiness care providers. particular within the literature, this quantity brings jointly unusual clinicians and policymakers who specialise in the operational elements of constructing cutting-edge built-in supply platforms. -History and conceptAWhy we'd like built-in future health care supply platforms, together with a version of carrier supply integration that includes present boundaries (e.g., ambiguous roles and duties and shortage of strategic alignment; tips on how to layout built-in supply platforms bettering medical results, attaining financial and working efficiencies, and aligning scientific and financial incentives) -Structural foundationsAAccess to the method of deal with sufferers, payors, and employers; tips on how to layout level-of-care standards; 8 innovations that support consumers circulate alongside the continuum; how to find point of care in todayAs controlled care international; and the method of following healing approaches (i. e., philosophies, methods, and practices used to create or help restoration and wellbeing) around the continuum -Administrative and administration processesAHow to reorient employees towards minimizing limitations and making the sufferer significant to the method; documentation/information administration and repayment (rates and cost buildings, probability assumption); present examine and its huge, immense power to enhance each point of care; caliber checks in line with analyzing the riding forces in the back of the wishes for tracking and comparing caliber and results; and the relation of behavioral wellbeing and fitness care structures, which search to totally combine consumers and households into the cloth in their group and tradition, to different platforms A case vignette that highlightsAfrom the consumerAs viewpointAthe very important position of self-help in the course of an episode of hospitalization and a dialogue of destiny instructions in built-in behavioral well-being care around out this amazing quantity. With its wealth of strategic and Anuts and boltsA informationAuseful for alliances and unmarried entities alikeAon find out how to harness operational forces in constructing a good built-in behavioral health and wellbeing continuum, this quantity might be welcomed by way of those that convey direct providers (psychiatric pros) and people who administer and deal with the built-in financing and supply of caliber care from public (U.S. executive organizations) and personal (managed care and coverage companies) sectors alike.

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D. A s a concept, service delivery integration is paradoxical; it is obvious yet subtle, simple yet complex, attainable yet elusive. In any health care organization the need to coordinate efforts is obvious, yet disorganization is commonplace. Cooperation is a simple courtesy taught in childhood, yet factions within organizations compete with one another. Well-intentioned efforts to address these issues begin with attainable objectives clearly in sight, yet all too often they end in failure. A clear vision for service delivery integration is essential in resolving these paradoxes.

However, although the resultant entity may bring about aspects of structural alignment, the arrangement may or may not actually achieve the aim of full organizational alignment. Also, within single organizations, the concept of organizational alignment may not even be recognized as a vehicle for service delivery integration. Organizational alignment is defined by a number of characteristics, as reflected in Table 2–2. , mergers, partnerships, joint ventures, strategic alliances, physician–hospital organizations) Leadership and vision Financial alignment Uniform financial management processes Alignment of provider incentives Centralized information management platform and processes Full integration of registration, master patient index, billing, finance, reporting and decision-support functions Finance management Information management Clinical dimensions Continuum of care Access Program boundaries Patient flow Personnel resources Facility resources Programming resources Clinical information Comprehensive range of coordinated, complementary services Centralized patient access to all system components 24 hours per day Flexible program boundaries that allow for permeability of resources Coordination of care across all service components Shared clinical protocols or pathways Case management Systemwide milieu Uniform policies that emphasize cross-training and flexible deployment Redefining the team Space design that promotes patient flow, efficiency, and sharing of resources Continuum-based programming that extends across levels of care Continuous medical record Clinical electronic medical record The Integrated Behavioral Health Continuum Component 20 TABLE 2–1.

Frequently the transfer process is fraught with ambiguity, a sense of disorganization, or even open tension. For a patient population that already feels helpless and out of control, such frustrations adversely affect patient care outcomes. Model of Service Delivery Integration 27 Seamless patient movement represents an important ideal in any integrated system of care. It is pursued by identifying and removing any “bumps” that might interfere with the patient’s journey through the system. Such bumps include any aspect of care that may be experienced by the patient as disruptive, unclear, repetitive, inconvenient, conflictual, or uncomfortable, particularly at juncture points.

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