Unit Five: Care Coordination, Collaboration, & Teamwork

Chapter 25: Clinical Practice Scenarios

Unit Five: Class Five

Learning Objectives

5.5.1. Demonstrate the ability to conduct brief, evidence-based and developmentally appropriate screening and collaborative care plan.
5.5.2. Demonstrate the ability to create and implement integrated care plans, including an array of linked services.
5.5.3. Organize and deliver services with an understanding of the impact on the team based care on billing, reimbursement, and healthcare coverage.
5.5.4. Explain how you might utilize an electronic health record to document the service provided and follow-up plan to ensure communication between the patient and care team, while maintaining HIPAA privacy.
5.5.5. Formulate a plan to measure and monitor health outcomes to fulfill patient quality care standards and healthcare purchasing agreements.


Student Research and Clinical Practice Scenario


Integrated Behavioral Health: Program Case Studies; Final Report March 2010 

Desert Vista Consulting, LLC: Jennifer J. Brya, MA, MPP & Karen W. Linkins, Ph.D. The California Endowment funded the Integrated Behavioral Health Project (IBHP)

This report presents case studies of six clinics; how to “make the case” for integration and lessons learned.  It demonstrates what the final project write-up should look like and gives great examples of how other clinics have developed practice management strategies to implement integrated behavioral health programs in primary care settings.  This report is in addition to demonstrating a scenario.  The scenario will demonstrate how students plan to deliver services.  Some examples include an initial visit, warm hand-off with brief intervention, patient flow billing and/or referral process with customer service, case review with consulting team members, or team huddle.

Link:  http://www.ibhpartners.org/wp-content/uploads/2015/12/IBHPCaseStudiesFINAL.pdf

Jeanette Waxmonsky, PhD., Andrea Auxier, PhD., Pam Wise Romero, PhD., Bern Heath, PhD.
The Integrated Practice Assessment Tool (IPAT) is used to place practices on the level of collaboration/integration defined by A Standard Framework for Levels of Integrated Healthcare issue brief. The IPAT uses a decision tree model rather than a metric model. This more accurately mirrors the issue brief tables, and avoids the need to weigh responses to questions, which may result in an in-between assessment score (e.g., a 3.75 co-location). The decision tree model uses a series of yes/no questions that cascade to a specific Level of Integrated Healthcare determination.

Link: http://ipat.valueoptions.com/IPAT/

TOOL 4: COMPASS Primary Health and Behavioral Health (Trade Marked): A Self-Assessment Tool for Behavioral Health and Primary Health Clinics and Programs

The COMPASS-Primary Health and Behavioral Health™ (COMPASS-PH/BH) is a continuous quality improvement tool for clinics and treatment programs, whether working in their own integration process or in partnership with others, to organize themselves to develop core integrated capability to meet the needs of service populations with physical health and behavioral health issues.

Link: http://www.integration.samhsa.gov/operations-administration/OATI_Tool4_COMPASS.pdf


The SAMHSA-HRSA Center for Integrated Health Solutions (CIHS)

Designed by a team of integration experts, the Organizational Assessment Toolkit for primary and behavioral health care Integration (OATI) provides a compendium of tools that lay out a path for organizations to assess their readiness for integration, as well as bench-marking opportunities for those organizations well down the line in integration efforts. This is a practice management and administrative tool.

Link: http://www.integration.samhsa.gov/operations-administration/OATI_Overview_FINAL.pdf

The Implementer’s Guide To Primary Care Behavioral Health
Edited by Neftali Serrano
This book is available for download with iBooks on your Mac or iOS device. Multi-touch books can be read with iBooks on your Mac or iOS device. They note books with interactive features may work best on an iOS device. iBooks on your Mac requires OS X 10.9 or later.  This is a guide to implementing the integrated model of care called Behavioral Health Consultation. It is based on the Access Community Health Centers program in Madison, WI.  

Link: https://itunes.apple.com/us/book/implementers-guide-to-primary/id833906873?mt=11

The Institute For Behavioral Health Integration

“IBHI assists primary care clinics with the integration of behavioral health services into their day to day operations. We also assist behavioral health agencies to integrate primary care services into their day to day operations. Managed care organizations face challenges in translating the potential of integrated care into actual changes in their own internal operations and their management of their health networks. IBHI provides consultation services which are designed to address these challenges.”

Link: http://bhintegration.org/



Icon for the Creative Commons Attribution 4.0 International License

Integrating Behavioral Health & Primary Care by Whatcom Community College is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

Share This Book