Understanding the experience of care managers and relationship with patient outcomes: the COMPASS initiative

被引:19
作者
Coleman, Karen J. [1 ]
Hemmila, Tani [2 ]
Valenti, Mark D. [3 ]
Smith, Nasya [4 ]
Quarrell, Rachel [4 ]
Ruona, Lynnice K. [5 ]
Brandenfels, Emily [6 ]
Hann, Barbara [7 ]
Hinnenkamp, Todd [8 ,9 ]
Parra, Margarita D. [1 ]
Monkman, Jeyn [2 ]
Vos, Sue [8 ,9 ]
Rossom, Rebecca C. [10 ]
机构
[1] Kaiser Permanente Southern Calif, Dept Res & Evaluat, 100 S Los Robles Ave,2nd Floor, Pasadena, CA 91101 USA
[2] Inst Clin Syst Improvement, 8009 34th Ave S,Suite 1200, Bloomington, MN 55425 USA
[3] Pittsburgh Reg Hlth Initiat, 650 Smithfield St,Ctr City Tower,Suite 2400, Pittsburgh, PA 15222 USA
[4] Mt Auburn Cambridge IPA MACIPA, 1380 Soldiers Field Rd,Floor 2, Brighton, MA 02135 USA
[5] Kaiser Permanente Colorado, Inst Hlth Res KPCO, POB 378066, Denver, CO 80237 USA
[6] Community Hlth Plan Washington, 720 Olive Way,Suite 300, Seattle, WA 98101 USA
[7] Mayo Clin Hlth Syst, 1000 First Dr NW, Austin, MN 55912 USA
[8] Essentia Hlth Duluth Clin, 420 E First St, Duluth, MN 55805 USA
[9] Michigan Ctr Clin Syst Improvement Mi CCSI, 233 E Fulton St,Suite 20, Grand Rapids, MI 49503 USA
[10] HealthPartners Inst, 8170 33rd Ave S,MS23301A, Bloomington, MN 55425 USA
关键词
Process improvement; Complex patients; Social and nonmedical needs; Collaborative care; Depression; DEPRESSION; INTERVENTIONS; POPULATION;
D O I
10.1016/j.genhosppsych.2016.03.003
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Objective: To understand how care managers implemented COMPASS and if this was related to patient health outcomes. Methods: A total of 96 COMPASS care managers were approached to participate in the online survey and 93 (97%) provided responses. Correlations were generated between key survey responses and the average number of care management contacts, patient depression, blood pressure and glycosylated hemoglobin outcomes. Results: Patients of care managers who reported spending more time on COMPASS-related tasks had higher rates of depression improvement (r=0.34; P=.002) and remission (r=0.27; P=.02) as well as higher rates of blood pressure control (r=0.29; P=.03). Conclusions: To improve the effectiveness of care management in collaborative care models, particularly for patients with comorbid conditions and complex nonmedical needs, care managers need the support of social work and administrative support staff. Care managers for this patient population would also benefit from more intensive training in nonpharmacological depression treatment, such as motivational interviewing and behavioral activation. Additionally, systems support is needed such as education for primary care teams and psychiatry on the value of collaborative care models and integration of population management tools into electronic medical records. (C) 2016 Elsevier Inc. All rights reserved.
引用
收藏
页码:86 / 90
页数:5
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