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Architecting an integrated behavioral healthcare delivery system utilizing evidence based clinical guidelines and symptom/functioning based outcome measurement: Revisiting the Pittsburgh Project

Frank A. Ghinassi, PhD, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA 15213-2593, 412 246 6811, ghinassifa@upmc.edu

The Western Psychiatric Institute and Clinic (WPIC), a large academic medical center serving over 40,000 psychiatric patients annually, has implemented and integrated into practice its long standing tripartite mission of clinical service, research and teaching in new ways. This presentation will describe how WPIC, using fully integrated clinical pathways and care management guidelines, an outcomes feedback system, and an electronic medical record has bridged regulatory compliance and quality improvement. Examples of the natural harmony between these constructs including how best practices and outcomes have been integrated into most levels and sites of care will be presented with suggestions for an alternative paradigm. One example, the Women’s Intensive Outpatient Program (WIOP),which was designed for highly acute patients stepping down from or being diverted away from inpatient care, will be described in detail. A process for guideline development will be summarized, tools for outcome selection reviewed, and a method of benchmarking presented. This presentation will also discuss the complexity and refinement of a measurement system that involves the judicious integration of 1)subjective, experiential data and more objective data such as claims and pharmacy data; 2)internationally validated and accepted measures of patient acuity, community tenure, work/school involvement, treatment engagement and retention and 3)utilization data from both behavioral and physical healthcare services. Advances in measurement technology and new data demonstrating improvements in services from the previous year's program will be included.

Learning Objectives:

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Innovative Strategies in Mental Health Outreach and Treatment

The 132nd Annual Meeting (November 6-10, 2004) of APHA