Chapter 09 Care Coordination and Continuity in Health Care Settings and the Community Powerpoint
Mental Health Care in the Community - PowerPoint PPT Presentation
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Mental Health Care in the Community
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Mental Health Care in the Community Chapter 5 – PowerPoint PPT presentation
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Title: Mental Health Care in the Community
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Mental Health Care in the Community
- Chapter 5
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Continuum of Care
- Ongoing clinical treatment and care matched with
intensity of professional health services - Care provided over time
- Facilitates stability, continuity and
comprehensive services - Achieve the highest level of functioning possible
within the context of the illness and in the
least restrictive environment
3
Coordination of Care
- Integration of appropriate services
- Services tailored to clients strengths and
limitations - No duplication of services
- Collaboration among services
- Case management, often by a nurse
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Generalist Case Management Services
- Brokerage service
- Does not necessarily provide the needed services
- Links the individual with the services
- Patients are usually outpatients with high-level
service use. - Staff-to-patient ratio is about 130.
5
Case Management Services
- Therapeutic tool in providing clinical services
or as a brokerage system for coordinating care - Goal To act as a patient advocate by increasing
access through coordinated efforts
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Nurse as a Case Manager
- Community knowledge necessary
- Special training in psychopharmacology, therapies
and psychosocial rehabilitation - Skills needed include
- collaboration
- teaching
- management
- leadership
- group
- research
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Components of CareInpatient Care
- Crisis Interventions
- Acute Inpatient Care
- Partial Hospitalization
- Residential Services
- Respite Residential Care
- In-home Mental Health Care
- Outpatient Care
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Other Services
- Outpatient Detoxification
- In-home Detoxification
- Assertive Community Treatment
- Psychiatric Rehabilitation
- Clubhouse Model
- Relapse Prevention
- Alternative Housing Arrangements
- Board-and-care homes
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Assertive Community Treatment
- Interdisciplinary team approach that provides a
comprehensive range of treatment, rehabilitation
and supportive services - Goal To reduce recurrences of hospitalization
- Core elements include
- interdisciplinary team responsible for a small
group of patients (110) - assertive outreach treatment to patients ADLs,
grocery shopping, etc. - treatment plan of care
- ongoing treatment and support
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Alternative Housing Arrangements
- Personal Care Homes
- Board-and-care Homes
- Therapeutic Foster Care
- Supervised Apartments
- Clubhouse Models
- Relapse Prevention After-care Programs
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Managed Care
- Efforts to coordinate patient care efficiently
and cost-effectively - Goals To increase access to care and provide the
most appropriate level of services in the least
restrictive environment - Typical services provided
- utilization management
- care management
- employee assistance program
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Managed Care
- Public and private collaboration
- Role of nurse
- Maximize time with patient.
- Focus on teaching social skills and prevention of
relapse. - Teach self-reliance, and create empowering
environments. - Provide crisis intervention and case management.
13
Psychiatric Rehabilitation
- Reintegration of persons with mental illnesses
into the community - Focus on increased functioning of persons with
mental illness - Structured program emphasizes acquiring skills
such as communication or vocation skills.
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Psychiatric RehabilitationRole of Nurse
- Adapt to the changing needs of persons with
mental illness. - Match the symptoms with an accurate diagnosis,
and engage the patient in an appropriate trial of
medication. - Monitor target symptoms.
- Assess and educate on compliance issues, lab
work, environment and lifestyle.
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Discharge Planning
- Begins when an individual enters the setting
- All activities recorded
- Discharge Checklist
- Text Box 5.2
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