Interprofessional Primary Care Outreach for Persons with Severe Mental Illness
The Interprofessional Primary Care Outreach for People with Mental Illness (IPCOM) project aims to increase access to primary care services for persons with severe mental illness served in behavioral health residential treatment programs by enhancing communication and interprofessional collaborative practice.
Background
The Interprofessional Primary Care Outreach for People with Mental Illness (IPCOM) project develops a unique nurse-managed interprofessional multisite primary care practice for the severely mentally ill. Utilizing a long term NP led primary care outreach practice for medically complex patients with mental illness, the IPCOM project focuses on development of communication systems and infrastructure to facilitate collaboration across disciplines that currently operate in parallel fashion. The interprofessional teams consist of a nurse practitioner, psychiatrist, pharmacist, dentist, and mental health staff. The population served has high acuity for both mental health and medical conditions, is ethnically and culturally diverse, and are predominantly homeless and from neighborhoods designated as health professional shortage areas. Existing literature confirms that a lack of collaboration across disciplines increases morbidity and decreases quality of care in this population.
Methods
New teamwork and communication strategies instituted in IPCOM include: education about the interprofessional core competencies and the patient-centered health home for all team members, including students; introduction of huddles across disciplines; quality improvement projects involving students and focused on residential staff and client education to include smoking cessation and chronic pain management; and, introduction of an electronic health record for primary care charting, with decision support and outcome tracking for metabolic monitoring, referral for HIV screening, and smoking cessation outcomes.
A number of tools are used to evaluate IPCOM outcomes, including client, student, and other team member outcomes. This poster will present findings on two measures: client factors to include socio-demographic, diagnoses, medications, with NP interventions captured electronically on each primary care encounter during the first 12 months of IPCOM; and, team member perceptions of collaboration, measured over time to include baseline, 6 and 12 months, with the Collaborative Practice Assessment Tool (CPAT) (57 items).
Conclusions
Enhanced communication with interprofessional collaborative practice strategies in this unique NP practice model has high potential for increasing access to and improving the quality of primary care for persons with severe mental illness. IPCOM lessons learned during year one will be discussed, with an outline of year two goals and objectives.