APM Annual Meeting 2015 Highlights: Day 5

Last day for us. Yesterday evening I attended the session “Medical Psychiatric Inpatient Integrated Care Models: History, Challenges and Benefits Shared by Four Institutions.” My colleagues Dr. Vicki Kijewski and Dr. Gen Shinozaki were presenting and moderating, respectively.

It was very interesting to learn of the other methods that exist to approach the challenge of providing concurrent medical and psychiatric care rather than fragmented, sequential kind so typical of our present system.

Dr. David Hilden (internal medicine hospitalist) of Hennepin County Hospital in Minnesota described their solution of embedding internal medicine hospitals in the psychiatric units, providing 365/24/7 acute medical care for psychiatric inpatients. The hospitalists who attend on the units do it because they enjoy it…they need no other incentive.

Yes, Virginia; there really is a Santa Claus!

The representatives from Hackensack University Medical Center described a very cost-effective solution with a medical-psychiatry unit that provides a clearly integrated approach which is strongly supported by hospital administration. They’ve been successfully implementing the program for about the last 10 years.

Dr. Vicki KijewskiDr. Kijewski delivered a detailed summary of our hospital’s 15 bed medical-psychiatry unit (or complexity intervention unit a term preferred by the founder, Dr. Roger Kathol), really the only unit of its kind in the region.

Representatives from Long Island Jewish Medical Center discussed the pros and cons (most successful also, in my humble opinion) of their own solution with a collaborative team approach making practical use of very experienced nurses already familiar with a holistic and patient-centered care approach.

One of the common features from several of the presenters is the success of case conferences which engage learners at every level from medical student t0 faculty member.

What’s apparent from all of their systems is now closely knit they are interpersonally and professionally. Selling the idea of integrated medical-psychiatry inpatient units was complicated and an uphill battle for many of us. I think these systems prevail, not so much on whether or not they’re cost-effective–but because the clinicians, nurses, social workers, and other stakeholders believe passionately that what they provide for patients truly helps them heal.

Bits and pieces:

Although they had daily Mindfulness Meditation sessions here, I didn’t go because they started at 6:15 in the morning and I do my mindfulness practice in the evenings, even here in this over–furnished hotel room.

Yesterday, I got a “Final Notice Alert” from the Clozapine REMS Program about somebody else’s patient. I wonder what happens after the “final notice”?

The APM meeting was about much, much more than what I’ve outlined here in the past few days. All I could give you was a bare glimpse of what I have experienced. There are many concurrent workshops going on all hours of the day. You really can’t get a feel for it unless you attend. You could join, in fact.

Just remember; once you become a member…you’re in it for life because there’s no getting out

I’m on my way to the presentation “Doc to Doc: Maximizing the Impact of Consultation Documentation,” led by Drs. Jeanne Lackamp, Vicki Kijewski, and Zafar Zaidi.

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