Virna Little, PsyD, LCSW-r, SAP

The Institute for Family Health

Mission Provide care to those who need it most

Use the family practice model of care

Train students and health professionals

Promote diversity in the healthcare workforce

Participate in health services research and policy development

Staff and Budget Over 900 staff members (Manhattan, Bronx and Upstate)

A budget of approximately 92 million dollars

450,000 visits yearly

Equal numbers of behavioral health staff

Medical, dental, pharmacy and mental health programs Special programs/population Educational programs Research Health Information Technology

6 Manhattan Centers

5 Bronx Centers

6 Mid-Hudson Centers

2 Free Clinics

8 Care for the Homeless

sites

5 Ryan White HIV/AIDS

programs

7 Mental Health Centers

• Manhattan and the

Bronx in New York City

• Mid Hudson Valley

• Diverse economic and social backgrounds

• Latino, African-American, Caribbean-American, or recent immigrants

Roughly 100,000 patients make about 600,000 visits per year

Senior leadership

CEO Zero Suicide Pledge

Medical Director – first meeting agenda always meeting agenda

Director of Suicide Prevention

EPIC

RCA’s

Better tracking and reporting

Mandatory training for ALL agency staff

Provided free for our staff through

community training initiatives

To date almost 1,000 trained

SAFETALK , AMSR

Training plan for all staff in the organization by job title

Electronic health record implementation in 2003

EPIC electronic health record system

Decided to use technology to help in identification and prevention of suicide in primary care patients throughout system

10

Collaborative Documentation

An ongoing challenge……

Used consistently throughout health centers

Speak the same language

Attention to question 9

Graphing Results

“Blows” into all encounters

Readily seen by providers of all disciplines

Able to be reported on ( number of patients)

My Safety Plan document ◦ Allows safety plan information to be available to all

providers during all visits for review and/or modification

◦ Patients can access the document via patient portal for reference

◦ Community providers can see patients at risk through physician portals

◦ Provided in print to patients as part of after visit summary

◦ Signed by patient and provider

A patient portal is a healthcare related online application that allows patients to interact with their healthcare providers.

What is a Patient Portal?

Suicide Risk Assessment

Operational Reporting Populations

New to behavioral health providers

Operational Reporting Key Parameters

Depression Registry

Physician portal as link to community

Almost 200 organizations and specialty providers on “Institute Link”

Foster care, mental health residences, DD programs

Pharmacy providers

Seamless care system

By-pass admissions

Expedited services

Decreased admissions

Overview of content in Medical Record

Review of all patients completed and attempts –analysis

Review of all deceased patients

Hard stop for patients who are considered high risk

Participation in local, state and national initiatives

Learning to look to system to “solve problems”

Training, training and more training

Continued “buy in” from primary care providers

Lethal means- system alerts for risk tied to interventions such as medications or gun locks

Better data tracking and reporting from external sources

Be prepared better reporting means higher rates