NIATx Wisconsin Mental Health Readmissions Collaborative

Project Description

Statement of Problem

The number and cost of care for the persistent and severely mentally ill continues to grow in Wisconsin. Residents of Wisconsin also have a higher rate of use of state psychiatric hospitals (Mendota and Winnebago) and community inpatient psychiatric services compared to the national average.

At the same time state and county budgets are shrinking due to reduced revenue. The Governor’s Budget includes several measures aimed at reducing institutionalization and expanding community treatment for people with mental illness. As of January, 2010 Wisconsin counties will be required to contribute to the cost of care for children and elderly patients at state psychiatric hospitals. This change will increase the fiscal responsibility of Wisconsin counties at a time when county administrators are cutting services or raising taxes to offset reduced revenues.

Aim

The aim of the Wisconsin Mental Health Readmissions Collaborative is to reduce unnecessary/inappropriate admissions and readmissions to inpatient facilities among the state’s persistent and severely mentally ill.

We will work with the State Division of Mental Health and Substance Abuse Services to identify, recruit, and provide technical support to a collaborative made up of representatives of five to eight Wisconsin counties. Key stakeholders from the State Division of Mental Health and Substance Abuse Services, county governments and appropriate representatives of state and community based psychiatric facilities will also be invited to participate in the collaborative.

Method

NIATx, based at the University of Wisconsin–Madison will draw on its experience in designing change strategies and building learning collaboratives in behavioral health to create a tailored framework appropriate to the requirements of the critical stakeholders committed to reducing unnecessary/inappropriate inpatient admissions and readmissions in designated counties in Wisconsin.

This proposal has four primary components that are core elements of the NIATx collaborative model (see Figure 1).

Formalize the Project Plan

Prior to implementing the Wisconsin Mental Health Readmissions Collaborative NIATx will work with the Collaborative overall sponsoring committee to formalize a project work plan, agree on the scope of work for each stakeholder group, and develop an appropriate time line, etc.

This work will result in a work plan that includes the following components:

• Reaching consensus among key stakeholders on the overall aim of the project (i.e., reduce readmissions among severely and persistently mentally ill in specified counties).
• The development of performance expectations and a system for tracking progress.
• Development of an approach for recruiting and choosing participants in the collaborative.
• A convening strategy for the collaborative that outlines how training and coaching will be provided (e.g., face to face meetings and workshops, teleconferences, web discussion groups, etc.).
• Communicate pre work assignments to be completed prior to the kick-off workshop (e.g., 1-1 interviews with participants, walk-throughs, initiation of work plans, etc.).
• Connecting NIATx coaches with participant organizations.

These project planning tasks would be primarily done by the collaborative overall sponsoring team with the facilitation of NIATx. Figure 2 outlines the proposed framework for this project.