Proac­tive pro­to­col

Sys­tem puts fo­cus on bipo­lar pre­ven­tion

Modern Healthcare - - Special Section -

Since July 2009, emer­gency depart­ment vis­its have de­creased 40%, in­pa­tient ad­mis­sions by 62% and to­tal in­pa­tient days by 71% among bipo­lar pa­tients seen through Her­itage Val­ley Health Sys­tem’s Staunton Clinic for be­hav­ioral health, in Moon Town­ship, Pa.

To be more proac­tive in treat­ing these pa­tients, given their propen­sity to quickly de­te­ri­o­rate when early warn­ing signs aren’t rec­og­nized, the clinic in­sti­tuted a pro­to­col aimed at pre­vent­ing full-blown re­lapses. The dra­matic re­sults since the clinic’s In­ten­sive Ser­vice Co­or­di­na­tion Team im­ple­mented its method­ol­ogy have gar­nered Her­itage Val­ley the Spirit of Ex­cel­lence Award for Qual­ity.

“If they get ill and hos­pi­tal­ized, it’s a ma­jor set­back to the per­son’s func­tion­ing level,” says Michael For­tu­nato, base ser­vice unit di­rec­tor. “If you can di­vert the per­son and keep them from reach­ing that acute level of ill­ness, where they need to be hospi- tal­ized, their re­cov­ery is more likely to be on a steady course, with much less dis­rup­tion to their life.”

The new pro­to­col en­cour­ages pa­tients and their fam­i­lies to self-monitor and re­port in when cer­tain symp­toms arise, steps up train­ing for them to do so, calls for more fre­quent con­tact with In­ten­sive Care Man­age­ment per­son­nel and nurse med­i­ca­tion checks, and aims to sched­ule ap­point­ments within 72 hours of signs of de­te­ri­o­rat­ing mental health.

The clinic in­tends to ap­ply this ap­proach to other types of pa­tients, start­ing with schizophren­ics and schizoaf­fec­tives (com­bi­na­tion schizophre­nia and bipo­lar), but staff chose bipo­lar pa­tients first be­cause their ten­den­cies are more cycli­cal, For­tu­nato says. “That was prob­a­bly the pop­u­la­tion, start­ing off with

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