By Adrian Pellegrini, MD, Psychiatric Physician, Behavioral Health
Despite having negative side effects and limited efficacy, psychotropic drugs are frequently used in nursing homes, skilled nursing facilities and other post-acute care. Patients and residents can often have comorbidities, become aggressive, experience grief and loss and have negative mental impacts as a result of over-medication. These drugs have sedating properties, and when provided to nursing home residents with symptoms of dementia, the Centers for Medicare & Medicaid Services (CMS) views them as a form of “chemical restraint.” Because of this, CMS has committed to finding and implementing new practices that enhance the quality of life for patients.
Forming a Lasting Partnership
As a post-acute care physician, I witnessed medically unnecessary and startlingly prevalent usage of psychotropic drugs on geriatric populations. I started looking for a new approach. Recognizing the need to help reduce the use of these medications in nursing care facilities, I partnered with 17 facilities in Louisville, Kentucky, before determining that it was time to broaden my reach.
I contacted Dr. Wayne Tasker, TeamHealth’s Director of Behavioral Health Services, and we formed a natural partnership. Our goals aligned – quality care, continual education and strong teams. We both wanted to provide service-oriented behavioral health care to post-acute patients. More than this, though, we wanted to improve their quality of life. Partnering together and with our teams, we began implementing a model to reduce our reliance on psychotropic drugs in Louisville facilities.
The TeamHealth Approach
Our approach involves monthly behavioral meetings with an interdisciplinary team to review charts and determine the next steps in the patient’s care plan. Each month, we review one-third of the charts, meaning each patient chart receives an in-depth review four times per year. Together, we evaluate these charts to identify patients who could benefit from psychotropic medication reduction.
Team collaboration is what sets this model apart from other approaches to resident care. Our monthly behavioral meetings keep our teams aligned and eliminate excessive chart changes due to miscommunication. Not only does this benefit patients, but it also benefits our clinicians. Supporting clinical decision-making and alignment in our monthly meetings keeps our clinicians happier and more satisfied, empowering them to provide higher quality care.
With this approach, the focus is not just on care. We are also focused on improving quality of life for our patients. This aspect is as important as the medical care they receive.
Mutually Successful Partnerships
In the three years that I’ve been with TeamHealth, our model has been implemented in 26 facilities in Louisville. Our approach emphasizes quality care, collaboration and compassion. We work closely with our partner facilities to ensure the delivery of high-quality, compassionate patient care. This means becoming a part of the facility culture.
Through culture change and collaboration, we can help facilities whose metrics are above the state and national average for antipsychotic medications reduce those numbers within six months. Reducing antipsychotic medications also improves facility CMS star ratings. When we succeed, so do our partners. Our mutual successes empower us to provide high-quality care.
Continuing a Legacy of Quality Care
Quality patient care is at the core of TeamHealth’s foundation. But at the root of quality patient care are innovative approaches to this care and a clinician-focused culture. TeamHealth’s post-acute care service line provides an opportunity to become part of the “fabric of the facility,” where our teams are known, trusted and essential. As we continue to grow, we look forward to helping our partners create legacies of quality elder care in their communities.
To learn more about TeamHealth’s innovative post-acute care program, please contact us today.