Improving aftercare effectiveness.

this article describes the results of a short structured phone interview about follow-up after psychiatric discharge with 20 high volume facilities. several reported differences were found between facilities that had high versus low rates of follow-up after discharge. A managed care organization studies what helps patients keep outpatient appointments after inpatient discharge by Jeffrey schwartz, ph.D., Deirdre hiatt, ph.D., george hargrave, ph.D., ABpp and Ian shaffer, mD, mmm. one of the most frequently reported behavioral health quality indicators is the heDIs measure of percentage of outpatient appointments kept within 7 days of an inpatient psychiatric discharge. In its 2005 state of health care Quality report, the national committee for Quality Assurance (ncQA) states that “Appropriate treatment and follow-up of mental illness can reduce the duration of disability from mental illness and the likelihood of recurrence.”1 studies have identified inpatient facility practices related to higher rates of patients keeping follow-up outpatient appointments. these include: presenting predischarge illness fact sheets combined with verbal reinforcement; scheduling appointments as soon as possible after discharge; 2-4 having staff contact the outpatient clinician before discharge; 5 ensuring communication between inpatient staff and the outpatient clinician about a patient’s discharge plan; having the patient start the aftercare program before discharge; and Involving the family in treatment. 6 other studies have identified interventions not effective in improving aftercare compliance. these include: having a predischarge, physician-led educational intervention; 7 having the patient meet the outpatient therapist before leaving the hospital; having the patient attend outpatient discharge groups; 8 and Using intensive care management strategies. 9 given the importance of aftercare engagement, managed health network, Inc. (mhn), a managed behavioral health organization, compared the inpatient facilities in our network that achieved the highest rates of outpatient follow-up with those that achieved the lowest, with the goal of determining those processes that differentiated the two groups. »