1. Behavioral Health
JPS Health Network
Wayne Young, MBA, LPC, FACHE

2. JPS Behavioral Health JPS Health Network offers robust
Behavioral Health services.
2016 Behavioral Health volumes:
20,000 psychiatric emergency visits
39,000 psychiatric inpatient days
2,800 psychiatric observation days
5,900 partial hospitalization days
28,500 psychiatric outpatient visits
80,000 depression screenings in primary care
Four partial hospitalization programs
Psychiatric Emergency Center
Two psychiatric hospitals
(96 and 36 beds)
Day rehab
for the homeless
Virtual Behavioral Health Clinical Guidance
Integrated Medical Unit
Psychiatric Emergency Center Visits
Eight primary care clinics with embedded behavioral health specialists
Six behavioral health clinics
Walk-in behavioral health clinic
Eight Peer Support Specialists
One behavioral
health school-
based clinic
Psychiatry residency program

3. Risk for Readmission
Phase 1: Patient Interviews (10) using standardized format
Phase 2: Chart Reviews (250) using standardized tool
Phase 3: 30 Day Readmission Calculation
Phase 4: Reviewed Observed : Expected Ratios for insights
Phase 5: Predictive Model analysis process
Phase 6: Created Risk Assessment Tool with predictors weighted based on degree of correlation
COLUMN CRITERIA POINT VALUE
DiagClass Bipolar Disorder 2
DiagClass Psychosis 2
DiagClass Schizophrenia 2
DiagClass Substance Abuse 2
AgeRange
Race_Name BLACK OR AFRICAN AMERICAN 1
Race_Name ASIAN
Ethnic_Name NOT HISPANIC OR LATINO 2
patientzip
patientzip

4. Developing Intervention Menu
Series of 45 Rapid Cycle Improvement Tests:
Discharge Scripting (2 cycles)
AIDET to improve DIScharge Communication (4 cycles)
MHMR/PEC Follow-up Appointments (4 cycles)
Improve the electronic reporting of readmission data. (5 cycles)
Multi-disciplinary Treatment Team Meeting & Documentation (2 cycles)
Discharge Planning Checklist /Script (3 cycles)
Injections: Transition from Inpatient to Outpatient Care (3 cycles)
JPS Connections Access Improvement (4 cycles)
Behavioral Health Follow Up Appt Reminders: Survey Patient Preference Text or (1 cycle)
Behavioral Health Follow Up Appt Reminders by texting or (2 cycles)
Behavioral Health Follow Up Appt: Provide a incentive for attendance (2 cycles)
BH Follow Up Appt: Bridge Visit provided by Transition Coordinators for High Risk Patients (1 cycle)
BH Follow Up Appt: Peer Support Specialist will f/u w/ patient regarding follow up reminders and provide group (3 cycles)
After Care Services focus group: Increase adherence to PHP/IOP (2 cycles)
After Care Services Group Facilitated by Peer (patient selection regardless of unit) (2 cycles)
Psychiatric Emergency Center Discharged : Transition Aftercare Information Sheet (3 cycles)
Post F/U 1:1 visit w/SW & I am Wellness After Care Transition Sheet (+ provider visit) (2 cycles)
My Passport Recovery folder: Guide to inpatient care through outpatient services (1 cycle)

5. Care Transition Interventions
Appointment with an Embedded Behavioral Health Specialist (EBHS)
Group Therapy with an EBHS
Appointment for counseling
Appointment with psychologist
Telephone Supportive/ Mentoring min.
Attend 1st appointment w/ patient and psychiatrist
Med Navigation & assistance programs
Referral to IST Team
Collaborate with community case manager
Family Education/Consultation Support
Disease Management Education
Recovery Messages sent by mail or
Setup appointment for home visit
Consultation w/Pharm D regarding meds
Assistance with establishing a PCP appointment
Assistance with JPS Connection Programs
Facilitate aftercare at a (non-JPS) Substance Abuse Treatment Center
Facilitate engagement with other community support groups
Referral to Partial Hospitalization Program
Engagement with Peer Support Specialist

6. 2014 Bill Aston Quality Award
Impact
2014 Bill Aston Quality Award
Data analyzed from statewide admission set obtained from DSHS