Illinois Division of Mental HealthQuality & Safety Improvement Initiative

Charter Team Topic: Treatment Recovery Philosophy & Policy

Hospital: Chicago Read Mental Health CenterQCSI III Charter Teams Report Out Meeting

June 24, 2013 – Springfield, IL

DRAFT: For Review and Discussion 1

Charter Team Members• Meredith Kiss, MA Quality Manager• Denise Blumenthal, LCSW• Gilda Vilches, MN, RN• Dr. Debra Marsico, PhD• Dr. Charles Stiava, PsyD• Celeste Januszewski, OTLR• April Meeks, MHT• Ashley Bae, LCSW• Laura Barrett-Bombe, OTLR• Dr. James Corcoran, MD• Judy Scott, Patient Advocate• Angela Espinosa, RHIT

DRAFT: For Review and Discussion 2

Treatment Recovery Philosophy and Policy: Overview of Deliverables

• Design, develop and pilot a training process that will ensure all staff have acceptable levels of knowledge and understanding of the Treatment Recovery Philosophy and Policy (TRPP)

• Develop processes and tools for evaluating patient and staff knowledge and understanding of TRPP

• Identify a core set of activities that indicate appropriate TRPP use and provide recommendations for related evaluation and monitoring of that usage

DRAFT: For Review and Discussion 3

QCSI Charter Team Work Process • Team Recovery met weekly in face to face meetings and established

mini task forces for each part of the planned initiative to report back the committee of ongoing progress

• “Recovery Liaisons” were assigned to each unit to solicit input from person(s) served about the task as their ability to participate in the live weekly meetings was difficult

• Resources from SAMHSA, NASMHPD and Yale University were researched and brought to the committee for review and sanction as viable tools and assessments

• Team Leader & Patient Advocate investigated the use of the Principles of Recovery at other respective hospitals as well as the role of the Recovery Specialist in staff direct training and intervention

DRAFT: For Review and Discussion 4

Difficulties/Barriers

• It was a requirement of the charter team task that there be participation by a person served. Identifying a patient who could attend weekly meetings without interfering with their treatment proved difficult. This barrier was resolved by establishing a “Recovery Liaison” from the committee for each unit to consult with patients and report back to the committee weekly.

• An anticipated barrier at time of full implementation is staff resistance in a cultural workforce with limited turnover.

• Despite efforts to incorporate a Recovery oriented component in the job description for every DMH employee, the office of the Director of Human Resources for DHS informed us this was not possible.

DRAFT: For Review and Discussion 5

Deliverables/Work Products • Design, develop and pilot a training process that will ensure all

staff have acceptable levels of knowledge and understanding of the Treatment Recovery Philosophy and Policy (TRPP)

Mandatory staff training will consist of 3 tiers

• New Hire Orientation • Annual Refresher• Opportunities for Improvement (incidental training)

• Drafted a proposed Program Directive for a Recovery oriented treatment philosophy to be adopted by each employee of DMH

DRAFT: For Review and Discussion 6

Deliverables/Work Products

• Develop processes and tools for evaluating patient and staff knowledge and understanding of TRPP

– Education in a computer based learning format as well as post-test materials for staff training

– Inclusion of a Recovery discussion in each daily Community Meeting format

– Recovery Stories: Guests living with a mental illness come to speak to staff and patients about their journey of Recovery bi-monthly

Deliverables/Work Products• Identify a core set of activities that indicate appropriate TRPP

use and provide recommendations for related evaluation and monitoring of that usage

– Recovery Rounds: An interactive process of evaluation of each treatment milieu conducted by a person served with a member of the Circle of Hope Committee

– A copy of the Principles of Recovery be provided to all persons served upon admission in their “Welcome Packets”

– Inclusion of a Recovery objective and Recovery competency in every DMH annual performance evaluation

Outstanding Questions/Issues

• Evaluation of patients’ knowledge of TRPP

Team Recovery initially considered a survey at discharge related to patient’s understanding of TRPP, however, the team felt it was redundant given the current Patient Satisfaction Survey already addresses Recovery in its instrument.

DRAFT: For Review and Discussion 9

Lessons Learned/Recommendations

• Recommendations

– It is Team Recovery’s belief that, in order to set the expectation that all staff embrace the Principles of Recovery while providing optimal care to patients, ongoing performance evaluations and related competencies must include a Recovery component. It is for that reason that Team Recovery reached out to the DHS Human Resources Director’s Office to propose an addition of Recovery to all DMH job descriptions and employee performance evaluations with an accompanying competency (as previously mentioned).

– Adopt and implement “10 Ways to Make Your Recovery Message Visible.” Guidelines on how to enhance your treatment settings to convey a look and feel of hope and recovery.

DRAFT: For Review and Discussion 10