Erin Sheehan
University of Massachusetts Amherst
Title: A Quality Improvement Project for Co-occurring Disorders in Outpatient Behavioral Health
Biography
Biography: Erin Sheehan
Abstract
Patients with mental health diagnoses often have co-occurring alcohol use disorders, which can exacerbate their psychiatric symptoms. A standardized assessment tool should be utilized for screening for alcohol use disorders in outpatient mental health programs so that interventions can be implemented when a co-occurring disorder is identified. The purpose of this project was to provide clinicians with education and to improve the process for screening patients with mental health disorders for problematic drinking behaviors to implement recommended interventions when appropriate to improve the overall quality of the patient’s care and increase the clinician’s knowledge and confidence in treating co-occurring disorders. Methods: The project design is a quality improvement model in a psychiatric intensive outpatient program that included education for clinicians, implementation of a standardized assessment tool and application of evidenced-based interventions for co-occurring disorders. The clinicians took a pre-test before the initial education session began and a post-test at the end and they participated in interviews throughout the entire project. Each education session included more evidenced-based interventions that clinicians could implement to improve the overall quality of care for their patients. The pre-tests, post-tests and interview data were collected, organized and analyzed for learning needs throughout the project and for evaluation and effectiveness of the interventions at the end of the project. Results: Out of 36 clinicians at the facility, 34 took the pre-test and 31 clinicians took the post-test. Findings revealed an increase in the mean scores of each of the Likert-scale questions on the post-tests after the education sessions were conducted except in question one because of a technical error. Qualitative data from interviews and responses to open-ended questions on the surveys were also collected, organized and analyzed. This qualitative data also indicated an improvement in the clinician’s knowledge and confidence in treating co-occurring disorders after the education sessions were provided. Conclusion: The participants of this project showed improvement in their knowledge and comfort level when assessing and treating patients with co-occurring disorders after participating in the education sessions. The short-term goals of the project were met, and clinicians also felt that the interventions were improving the overall quality of patient care. Future recommendations include adding a more comprehensive assessment for patients that scored positively on the AUDIT-C and continuing to provide education for clinicians on topics such as motivational interviewing, psychotropic medications, group psychotherapy and treatment and causes of delirium.