Challenges and Solutions
Possibly the greatest challenge for a large behavioral health organization is to ensure that there is clear communication between the various clinical units providing services to a patient.
Western Psychiatric Institute and Clinic (WPIC) needed PsychConsult to play an important role in the ongoing effort to improve continuity of care and facilitate patient safety measures. PsychConsult's integrated functionality enabled WPIC to ensure that the information about a patient and their treatment is:
- Accessible by ambulatory, inpatient, and emergency units
- Real-time
- Authenticated
Accessible
By having one central repository for information and documents pertaining to a patient, the risk of error associated with inconsistent, inaccessible, or misplaced information is greatly reduced. Each department can access the data necessary to do their work and be confident that others are working with the same set of information.
Real-Time
It would be common for one of our patients to move through several levels of care in a short period of time, making it especially critical that the information in the system is real-time. If a patient calls the crisis hotline, staff can search the system to see if they have called previously or received services. A quick review of the patient's record and documents could inform Call Center staff that the patient was recently discharged from an inpatient program and has been working with a therapist in the ambulatory unit for individual therapy. Should the patient arrive for a regularly scheduled outpatient appointment the next day, the clinician will be able to see that the patient contacted the crisis line several times since their last session. Availability of up-to-the-minute information about treatment history and medications allows staff to make fully informed decisions about a patient's treatment course.
Authenticated
PsychConsult lets staff feel confident that they are working with an accurate set of information about a patient. They do not have to rely on the patient's or their family's memory about dates, medications, or staff names. The system preserves a detailed record of all interactions that the patient or their family has with any part of the organization. It also preserves detailed information about additions or modification to the patient's record or documents. PsychConsult records user information and timestamps whenever a record is created, modified, or deleted, and supervisors can review these audit trails to investigate suspect activity.
Staff Training
Our organization made a concerted effort to ensure that staff are well trained in the use of the application. WPIC worked with Askesis' staff to create custom training materials that would prepare staff to take full advantage of PsychConsult's features. We chose a blended learning approach to strike a balance between the disruption of having to learn a new piece of software with the need to have focused trainings that were long enough for users to adequately learn the material. For each clinic, we broke the trainings into role-based sessions. This meant that they would not have to sit through instruction on features they would never use. Clinicians and administrative support staff typically attended four half-day sessions, while physicians were able to complete their training in one half-day session. In addition to print material, we also prepared multi-media training guides, accessible through the internet. These proved extremely valuable as pre-training and review materials. Staff noted that they found it effective to watch an animated demonstration of the tasks they needed to complete.
Successes
By far, the most important success of the implementation of PsychConsult at WPIC is in terms of continuity of care. The richness and immediacy of the information in PsychConsult is truly remarkable, providing staff with a comprehensive picture of the patient's treatment.
This level of continuity has resulted in extremely positive feedback from investigators conducting external reviews, such as JCAHO accreditation and Pennsylvania's Department of Public Welfare (DPW) state licensing. The excellence of our care delivery is gratifyingly reflected in the outstanding scores we receive. In many instances, PsychConsult has been cited as a major factor in the superior ratings. The compliments and formal commendations we've received from these groups are a powerful validation of the work we set out to do. It is common for inspectors, clinical experts who normally identify themselves as non-technical, to use words like savvy, elegant, and intuitive when talking about PsychConsult.
In a recent JCAHO review, inspectors used a 'tracer' methodology, reviewing the records of patients who moved through several levels of care over the course of time. They were extremely impressed with the extent of patient safety measures built into the application and commended the remarkable continuity of care the patients received. One self-avowed "anti-techie" commented, "You know, it just seems intuitive. Boy, even I could use this [application]."
Another telling comment came from DPW inspectors, some of whom began participating in WPIC's yearly review before PsychConsult was implemented. They noted that, although they only see the system once a year, it's so clearly organized that they remember how to use it.
Reviewers applauded the significant commitment to staff training, noting that it was extremely effective to have highly trained experts mentoring new users.
PsychConsult has also facilitated a noteworthy decrease in the time and resources required to prepare for review. The fact that records are electronic has put an end to the lengthy process of preparing paper charts for review. We no longer have to sort through the filing queue to ensure a complete chart, because the information is all in PsychConsult.
About WPIC
For more than 50 years, Western Psychiatric Institute and Clinic (WPIC) has been a national leader in the diagnosis, management, and treatment of mental health and addictive disorders.
As part of UPMC, WPIC not only provides the most comprehensive range of behavioral health services available today, but is also shaping tomorrow's behavioral health care through clinical innovation, research, and education.
Considered one of the nation's foremost university-based psychiatric care facilities, WPIC houses the Department of Psychiatry of the University of Pittsburgh School of Medicine. WPIC's international reputation attracts quality candidates from the world's finest clinical and research institutions. In addition to teaching medical students and directing a five-year psychiatric residency training program, WPIC offers nine federally funded research training programs for pre- and postdoctoral fellows.
WPIC is also a training center for graduate and undergraduate students from more than 20 colleges and universities, representing disciplines that include nursing, social work, education, childcare, and art and music therapy. WPIC's commitment to research has made it an international leader in discovering effective therapies. Some of the most successful treatments that are now standard throughout the world were pioneered at WPIC.
WPIC currently houses six federally funded Centers of Excellence:
As an academic partner of the University of Pittsburgh School of Medicine, WPIC and the Department of Psychiatry consistently rank first nationally in psychiatric research funding from the National Institutes of Health.
WPIC has consistently ranked among U.S. News & World Report's "Best of the Best" as one of the best psychiatric care providers in the United States. |
