Wood County Human Services Mental Health Collaborative 2010
Wood County Human Services Mental Health Collaborative 2010 -2011 Randall Ambrosius, MSW, LCSW, CSAC, ICS Wood County Human Services Department
Wood County Human Services Department n n Located in Central Wisconsin AODA / Mental Health Clinic located in Wisconsin Rapids Norwood Health Center located in Marshfield 24 hour Crisis Line Mobile Crisis Line n Legal Services n
Step One n Q: What do we want to focus on? Answer: Reduce hospital re-admissions at Norwood Health Center n Q: What is the current hospital re-admission? n
BASELINE Current re-hospitalization rate is 4% AIM Reduce re-hospitalizations 3% or less
Committee Membership n n n Wood County Unified Services : Randall Ambrosius, Treatment Services Manager Charlotte Smith, BHS Division Manager Kathy Roetter, Director Wood County Unified Services Norwood Health Center : Ray Dreager: Client Services Kristi Smith: Client Services Manager Pam Martinson: Health Information Manager Wood County Sheriffs Department: Robert Levendoske (Retired) Consumer: Joe Arts Doug Aughey Project Coach Tom Mosgaller: UW-Madison, NIATx
The Walk Through “What is it like to be a client? ”
NIATx Process § Plan: General change idea to be tested. § Do: What specific change did we put in place? § Study: What were the results of this change? § Act: Adopt, modify, or abandon the change idea.
Rapid Cycle Changes Action Results n Cycle One: Patient call crisis line 10% readmission n Cycle Two: Patient call crisis line 3. 3% readmission n Cycle Three: Norwood Social Workers call clients with script 0 readmission Low number wanting to be involved
Change Cont. n Cycle Four: n Cycle Five: Action Results Norwood Social Worker calls clients with script 0 readmission Low number wanting to be involved Norwood Staff (Nurse, psych tech, etc. ) Staff making calls to whom they have a connection. 0 readmission
Results
Summary of 2010 v v 1) The goal was 3% or less. During this process we averaged 1. 76% re-admission of those who participated. 2) Individuals who did not participate had a 5% average readmission. v 3) Low numbers of individuals to participate in support calls. v 4) The relationship is the most important factor.
Wood County Human Services Department Mental Health Collaborative 2011 Part II “The Big Aim and the Little Aim”
2011 AIMS n n Big Aim: Reduce hospital re-admissions at Norwood Health Center Little Aim: Increase the number of clients in support calls.
2011 Action Results Cycle One Improve script 2010 – 10 participated 10% re-admission 2011 – 30 participated 2% re-admission Cycle Two Con’t to use script 2010 – 17 participated 3. 3% re-admission 2011 – 21 participated. 05% re-admission 32 clients could not participate with a 19% re-admission rate. What happened?
Record number of hospital admissions occurring in cycle 2.
A Balancing Act “What to do? ” Have one hospital staff make calls and capture good data. Loss of relationship Con’t to have all staff make support calls - good relationships. Poor data, unable to capture everyone.
Action Cycle 3 v v One staff collects and makes support calls. Results 2010 – 7 participated 0% re-admission 2011 – 19 participated 1. 6% re-admission QUESTION - Should we use E-mail? ANSWER – No. Only 2% report having access to a computer. QUESTION - How many individuals are we reaching? ANSWER - 60% contact with individuals in support call program.
% Hospital Re-admissions
# of Participants in Support Calls
Hospital Readmissions
Making a Business Statement Cost per day of hospitalization… $1, 034 Average cost of every commitment… $4, 000 Clients feeling good about not being re-hospitalized… priceless!
Chapter 51 Detentions
Wood County Suicides
Next Steps (ACT) Review each client’s case Utilize Peer Specialists/Clubhouses Continue to have hospital staff make support calls Use a video to introduce support calls and resources
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