scholarly journals Implementation and evaluation of a pharmacist-run mental health treatment clinic via clinical video telehealth

2016 ◽  
Vol 6 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Molly Leach ◽  
Guadalupe Garcia ◽  
Nicole Ganzer
Keyword(s):  
Mental Health ◽  
Rural Areas ◽  
Mental Health Treatment ◽  
Medical Center ◽  
Medication Management ◽  
Health Resources ◽  
Cost Savings ◽  
Veterans Health ◽  
Health Administration ◽  
Potential Cost

Abstract Introduction: The Veterans Health Administration is extending its mental health services to reach those in rural areas who find it difficult to travel to a Veterans Affairs Medical Center (VAMC). This project aimed to outline implementation of a Pharmacy Mental Health Clinical Video Telehealth (MHCVT) clinic for veterans. Secondary endpoints were to assess patient satisfaction with MHCVT, describe the potential benefits of this clinic regarding travel saved, and summarize no-show rates. Methods: Veterans received mental health disease state medication management from a mental health clinical pharmacy specialist via clinical video telehealth (CVT) in place of an in-clinic appointment and were asked to complete a satisfaction survey after the initial CVT appointment. Data collected from all veterans enrolled in the CVT clinic from September 8, 2014, through March 23, 2015 included: patient demographics, service connection percentage, number of CVT visits, travel miles saved, travel reimbursement, no-show rate, and documentation of medication management therapy. Results: As of March 23, 2015, there were 22 veterans enrolled in the MHCVT clinic, of whom, 19 completed their appointments. Of the 48 potential encounters, 7 were considered a no-show (17%). On average veterans saved 34 travel miles per visit with cumulative savings of 1432.6 miles. Of those who were eligible to receive travel reimbursement (n = 13), the medical center potentially saved $674.50 in a 7-month period. Overall clinic satisfaction per survey (n = 14) was 100% (strongly agreed or agreed). A majority (93%) would recommend the clinic to other veterans. Conclusions: This project successfully implemented a MHCVT pilot clinic. The veterans were satisfied with the services. The 41 clinic visits resulted in a potential cost savings. Expansion of this clinic in the future will expand more mental health resources to veterans.

scholarly journals Impacts of a web-based educational program for veterans who read their mental health notes online

2018 ◽  
Vol 26 (1) ◽  
pp. 3-8 ◽  
Author(s):  
Lauren M Denneson ◽  
Maura Pisciotta ◽  
Elizabeth R Hooker ◽  
Amira Trevino ◽  
Steven K Dobscha
Keyword(s):  
Mental Health ◽  
Mental Health Treatment ◽  
Educational Program ◽  
Patient Activation ◽  
Patient Portal ◽  
Veterans Health ◽  
Health Administration ◽  
Perceived Efficacy ◽  
Web Based ◽  
User Input

Abstract Objective This study evaluates whether a web-based educational program for patients who read their mental health notes online improves patient-clinician communication and increases patient activation. Methods The web-based educational program, developed with end-user input, was designed to educate patients on the content of mental health notes, provide guidance on communicating with clinicians about notes, and facilitate patients’ safe and purposeful use of their health information. Eligible patients were engaged in mental health treatment (≥1 visit in the prior 6 months) and had logged into the Veterans Health Administration (VHA) patient portal at least twice. Participants completed measures of patient activation, perceived efficacy in healthcare interactions, patient trust in their clinicians, and patient assessment of the therapeutic relationship before and after participating in the program. A total of 247 participants had complete data and engaged with the program for 5 minutes or more, comprising the analytic sample. Multivariate analysis using mixed effects models were used to examine pre-post changes in outcomes. Results In bivariate analyses, patient activation, perceived efficacy in healthcare interactions, and trust in clinicians increased significantly between pre- and post-training assessments. In fully adjusted models, changes in patient activation [b = 2.71 (1.41, 4.00), P < 0.01] and perceived efficacy in healthcare interactions [b = 1.27 (0.54, 2.01), P < 0.01)] remained significant. Conclusions Findings suggest that this educational program may help empower mental health patients who read their notes online to be active participants in their care, while also providing information and tools that may facilitate better relationships with their clinicians.

Mental health and addiction service use among United States veterans with liver disease nationally in the Veterans Health Administration

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Lamia Haque ◽  
Robert Rosenheck
Keyword(s):  
Mental Health ◽  
United States ◽  
Drug Dependence ◽  
Mental Health Treatment ◽  
Addiction Treatment ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Health Treatment ◽  
Content Type

Purpose While many studies have shown that liver diseases (LD) can be caused or exacerbated by substance use disorders (SUD), few have examined the proportion of adults with LD and SUD who receive mental health and addiction treatment or correlates of such use. Design/methodology/approach Using national Fiscal Year (FY) 2012 data from the United States Veterans Health Administration (VHA), the authors studied all 43,246 veterans diagnosed with both LD and SUD in FY 2012 and compared those who received mental health treatment (n = 30,456; 70.4%) to those who did not (n = 12,790; 29.6%). Findings Veterans who received mental health treatment were less like to be older than 75 years of age, more likely to have served during recent Middle East conflicts (Operation Iraqi Freedom or Operation Enduring Freedom), more likely to have been recently homeless and to have drug dependence as contrasted with alcohol dependence when compared with those who did not receive mental health treatment. Although the majority, 70.4%, received mental health treatment, only 30.6% of the total received specialized addiction treatment, and these veterans were more likely to experience homelessness and have drug dependence diagnoses. Originality/value This is the first study as per the authors’ best knowledge that broadly examines mental health and addiction treatment received by veterans with LD and SUD. High rates of mental health treatment in this population likely reflect the integrated nature of the VHA and its emphasis on providing comprehensive services to homeless veterans. Further research is needed to identify barriers to specialized addiction treatment in this population.

Process mapping appointments to identify improvements in care delivered to patients who screen positive for depression

2016 ◽  
Vol 4 (3) ◽  
pp. 433
Author(s):  
Bo Kim ◽  
Stephanie Rodrigues ◽  
Natalie S Dell ◽  
Rani Elwy
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Treatment ◽  
Veterans Health ◽  
Health Administration ◽  
Depression Care ◽  
Positive Screen ◽  
Novel Approach ◽  
Using Data

Rationale, aims and objectives  After screening positive for depression, many patients do not receive effective medication or maintain optimal contact with practitioners.  Our objective was to examine how appointments that patients have after screening positive may affect the delivery of evidence-based and guideline-concordant depression care. Methods  We reviewed treatment records for 271 patients who screened positive for depression in primary care across three United States Veterans Health Administration medical facilities.  For each patient, we mapped the process of appointments that took place following the positive screen, noting the number of appointments, the service line in which each appointment was held, as well as whether guideline-concordant depression care was in turn received over four months. Results  We found that (i) approximately half of the patients who screened positive had no follow-up appointments, (ii) all patients who had two or more follow-up appointments received some – but not necessarily guideline-concordant – mental health treatment, and (iii) there were distinct patterns across the three facilities regarding which service lines’ appointments most often resulted in treatment. Conclusions  Our work offers a novel approach of using data on appointments that patients have after screening positive for depression to shed light on current care practices.  The number of post-screening appointments can be an informative process measure for improving depression care to become more guideline-concordant.  Facilities vary substantially in terms of which service lines they use to attain guideline-concordance, likely due to notable differences in how their primary care, integrated primary care behavioral health, and mental health services are organized.

Cultural Change: Implementation of a Recovery Program in a Veterans Health Administration Medical Center Inpatient Unit

2018 ◽  
Vol 25 (3) ◽  
pp. 208-217 ◽  
Author(s):  
James G. McDonagh ◽  
William Blake Haren ◽  
Mary Valvano ◽  
Anouk L. Grubaugh ◽  
Frank C. Wainwright ◽  
...  
Keyword(s):  
Mental Health ◽  
Cultural Change ◽  
Medical Center ◽  
Psychiatric Inpatient ◽  
Veterans Health Administration ◽  
Inpatient Unit ◽  
Veterans Health ◽  
Health Administration ◽  
Psychiatric Inpatient Unit ◽  
Recovery Program

INTRODUCTION:The Freedom Commission’s recommendations, Substance Abuse and Mental Health Services Administration’s framework, and policy directives on recovery-oriented services have fueled the recovery transformation. Mental health recovery services have been implemented in a broad range of outpatient settings. However, psychiatric inpatient units remained embedded in the traditional model of care. AIMS: The purpose of this article is to describe an ongoing quality improvement implementation of recovery services in a Veterans Health Administration acute psychiatric inpatient unit. METHOD: An interprofessional Partnership for Wellness delivered 4 to 6 hours per day of evidence-based recovery and holistic population-specific health programs. Veteran, system, and program indicators were measured. RESULTS: Preliminary indicators over a 2-year period suggest that Veterans rated group content and relevance high, pre–post psychiatric rehospitalization rates decreased by 46%, and fidelity to recommended strategies was high. CONCLUSIONS: The project success reflects strong leadership, a partnership of committed staff, effective training, and an organizational culture exemplifying excellence in Veteran services and innovation.

Applying Lean Six Sigma to improve medication management

2016 ◽  
Vol 29 (1) ◽  
pp. 16-23 ◽  
Author(s):  
Preethy Nayar ◽  
Diptee Ojha ◽  
Ann Fetrick ◽  
Anh T Nguyen
Keyword(s):  
Health Care ◽  
Six Sigma ◽  
Medical Center ◽  
Medication Management ◽  
Significant Proportion ◽  
Lean Six Sigma ◽  
Veterans Health ◽  
Health Administration ◽  
Content Type ◽  
Current Process

Purpose – A significant proportion of veterans use dual care or health care services within and outside the Veterans Health Administration (VHA). In this study conducted at a VHA medical center in the USA, the authors used Lean Six Sigma principles to develop recommendations to eliminate wasteful processes and implement a more efficient and effective process to manage medications for dual care veteran patients. The purpose of this study is to: assess compliance with the VHA’s dual care policy; collect data and describe the current process for co-management of dual care veterans’ medications; and draft recommendations to improve the current process for dual care medications co-management. Design/methodology/approach – Input was obtained from the VHA patient care team members to draw a process map to describe the current process for filling a non-VHA prescription at a VHA facility. Data were collected through surveys and direct observation to measure the current process and to develop recommendations to redesign and improve the process. Findings – A key bottleneck in the process that was identified was the receipt of the non-VHA medical record which resulted in delays in filling prescriptions. The recommendations of this project focus on the four domains of: documentation of dual care; veteran education; process redesign; and outreach to community providers. Research limitations/implications – This case study describes the application of Lean Six Sigma principles in one urban Veterans Affairs Medical Center (VAMC) in the Mid-Western USA to solve a specific organizational quality problem. Therefore, the findings may not be generalizable to other organizations. Practical implications – The Lean Six Sigma general principles applied in this project to develop recommendations to improve medication management for dual care veterans are applicable to any process improvement or redesign project and has valuable lessons for other VAMCs seeking to improve care for their dual care veteran patients. Originality/value – The findings of this project will be of value to VA providers and policy makers and health care managers who plan to apply Lean Six Sigma techniques in their organizations to improve the quality of care for their patients.

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