Administration & Systems Issues
General Session
Hochang Lee, MD, FACLP
John Romano Professor and Chair
University of Rochester School of Medicine
Rochester, NY
Michael Sharpe, MD, FACLP
Professor of Psychological Medicine
University of Oxford
Oxford, United Kingdom
Patrick Triplett, MD, DFAPA
Clinical Director and Physician Advisor, Department of Psychiatry and Behavioral Sciences
Johns Hopkins University School of Medicine
Baltimore, MD
Telva Olivares, MD
Director of Medicine in Psychiatry Services
University of Rochester
Rochester, NY
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Jane Walker, MBChB, PhD
Senior Clinical Researcher & C-L Psychiatrist
University of Oxford
Oxford, United Kingdom
Background:
Psychiatric co-morbidity is highly prevalent (20–40%) in hospitalized patients. It is associated with higher cost of care, poorer clinical outcomes, and staff dissatisfaction. There is consequently a great need for psychiatry to contribute to inpatient care. However there is limited evidence for the effectiveness of existing models of delivery of psychiatry in the medical inpatient setting.
New and innovative psychiatric service models are in various stages of development and evaluation in general hospitals in the United States and United Kingdom. Unlike the traditional consultation model of C-L psychiatry, these innovative models aim to provide more proactive and integrated behavioral and medical care for patients with comorbidity. These potentially transformative approaches to care appear to offer clear advantages whilst also introducing new challenges; we will explore the ways that these proactive, integrated models can be adapted to the audience’s home institutions.
Moderated by Dr. Sharpe this session will describe current innovative approaches to better integrating psychiatric care into inpatient medical services at a number of academic medical centers. We will also describe the developing evidence base for new approaches, including an ongoing multi-site, randomized trial of a proactive C-L model for older medical patients.
Talks
--Dr. Sharpe will introduce the topic and review the evidence for the traditional C-L psychiatry model of care then describe the experience of integration of psychiatry into medical teams in Oxford UK (15 minutes)
--Dr. Triplett will report the latest results from the proactive C-L model being implemented at Johns Hopkins Hospital and their efforts to achieve behavioral health service integration. (15 minutes)
--Dr. Olivares will describe a ‘reverse integration’ model that brings comprehensive medical care into inpatient and outpatient psychiatric settings based on their implementation of a Medicine in Psychiatry Service (MIPS) program in Department of Psychiatry at University of Rochester Medical Center (URMC). (15 minutes)
--Dr. Walker will describe the rationale and methods for a multi-site, randomized trial of a proactive C-L model for older medical patients—The HOME Study—that aims to recruit 3000 older patients across three sites in the UK. (15 minutes)
Discussion
The talks will be followed by commentary, panel discussion and Q & A Session led by Dr. Ben Lee. (30 minutes)