201776 Innovative outreach strategies for individuals with serious mental illness: House calls, group visits and telemonitoring

Tuesday, November 10, 2009: 4:45 PM

Emily S. Brigell, MS, RN , College of Nursing, University of Illinois at Chicago, Chicago, IL

Background: Individuals with serious mental illness (SMI) have a 25 year shorter lifespan than the general population due, in part, to a higher risk of co-morbid illness such as diabetes, hypertension and heart disease. The confluence of comorbid physical and mental illness, and limited resources create challenges to access to care. Integrated Health Care (IHC) is an academic nurse-managed center in which Family Nurse Practitioners (FNP) provide integrated primary and mental health care services to individuals with SMI in collaboration with a large, community-based psychiatric rehabilitation agency. Over 10 years, the clinic census has increased to over 900 clients per year, but services remain inaccessible to a significant number of homebound individuals with SMI.

Methods: IHC Without Walls (IHC WOW) is an innovative outreach program for hard-to-reach individuals with SMI using strategies that include nurse practitioner house calls, group visits and telemonitoring.

Results: The delivery of primary care via outreach interventions poses opportunities and challenges not encountered in clinic settings. This presentation will provide a critique of the operational structure and process development for each of the interventions and the impact on program outcomes. In addition, the presentation will describe the impact of larger health system changes. Program data on clinical outcomes, utilization and cost of service will be shared.

Conclusions: The higher incidence of chronic disease and shorter lifespan of individuals with SMI is a serious public health issue. The evidence from this innovative approach to primary care could facilitate improved outcomes for this vulnerable population.

Learning Objectives:
1. Describe an innovative program for hard-to-reach individuals with serious mental illness (SMI) using 3 outreach strategies: APN house calls, group visits and telemonitoring. 2. Describe the structure, process and outcome results of the first phase of implementation of each of these 3 outreach strategies. 3. Identify at least one encountered and improvement strategy employed.

Keywords: Access to Health Care, Primary Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the Director of the program about which I am presenting for almost 2 years. I was a co-author of an article in the journal of Home Health Management and Practice which was published in December 2008. The content of the article is about the program I will present at APHA. I received a Master of Science in Public Health Nursing from the University of Illinois at Chicago College of Nursing in 1997. I have experience presenting at a national conference-National Association of Home Care (NAHC).
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.