Elective rotation opportunities can be tailored for the resident’s interests and career goals. The resident’s training experience will include required rotations with the inpatient family medicine team, outpatient family medicine center and an administrative academic experience at Butler University. Each year, Community Health Network recruits one pharmacotherapy specialty resident with primary responsibilities at Butler University, Community Hospital East and the Community Group Family Medicine Center. So, the program should generate a return on investment, and it ensures that our members have access to high quality care.'Ĭhristopher Cheney is the senior clinical care editor at HealthLeaders.The Comunity Health Network pharmacotherapy residency started in 2009 and is designed to provide both clinical teaching and practical experience in the inpatient, outpatient and university settings.

'The cost of the case managers, which is the component that we are adding, should ultimately result in a net savings from reduced readmissions. The Transitional Outpatient Program should be a good example of a behavioral health initiative that generates a return on investment and improved clinical outcomes, Fleury says. That would be about 14 fewer readmissions per year,' she says. If we can achieve a 5% reduction in readmissions-taking into account the costs of the case managers-we expect to have about $118,000 worth of net savings per year. 'The main quality metric that we are looking at is readmissions-we are hoping to lower 30-day readmissions for members who go through this program by 5%. Readmissions are the primary metric being used to gauge the effectiveness of the Transitional Outpatient Program, says Sarah Fleury, LICSW, manager of behavioral health at Blue Cross & Blue Shield of Rhode Island. So, a medication provider will assess that and adjust medications as needed to make sure that medications are continuing to work for the patient.' In seeing a provider after patients leave the hospital, sometimes there are further medication adjustments as their symptoms improve or as they adapt to the medications. 'Patients often have medication changes done when they are in the hospital. Medication management is another key element of the Transitional Outpatient Program, Gaudiano says. We also make sure our therapists provide safety planning to reduce suicide risk.' Often, there is cognitive-behavioral treatment and short-term counseling that is provided. We want to make sure patients are supported in achieving those goals. 'Typically, it is a short-term model of care that identifies the patient's goals after hospital discharge. Therapy is individualized for the patients based on their mental health needs, he says. So, this program does not require completely new staff because we can repurpose some staff or expand their duties to include this new program.'

They are basically devoting some of their time for this new program, but they were already employed at the hospital. 'We also have the outpatient therapists and prescribers, which include psychiatrists. Two part-time case managers are the only new hires for the Transitional Outpatient Program, Gaudiano says. The case manager can help the patient access services for housing, financial issues, or other problems that they might be having,' he says. There might be several social determinants of health issues that a case manager can address and help the patient problem-solve. Often, patients need help with a variety of different issues that they are dealing with in the community. We feel that if patients have short-term case management, that extra support that patients need in a limited time can help to reduce rehospitalizations. 'Adding in case management provides an extra level of support and care that otherwise is not typical of care when patients leave the hospital.

The most innovative element of the new program is case management, Gaudiano says. How the Transitional Outpatient Program was implemented It is nonadherence problems and not being able to manage stressors effectively that trigger relapse and rehospitalization.' We can make sure that patients are being followed up, monitored, and reassessed for any kind of risk factors that might be developing. 'Our approach prevents things like nonadherence to treatment-we can make sure that we are supporting the patient, make sure that they can continue with their medication, and make sure that they can continue to get to their appointments. With the new program, patients get support from a team of professionals who work together to monitor the patients' situations, help them to problem-solve, and identify if there are certain needs that are not being met that can be addressed with services, Gaudiano says.

Butler outpatient