Patient centered care improving outcomes that matter to patients in the real world
Sponsored Links
This presentation is the property of its rightful owner.
1 / 11

Steven S. Sharfstein, M.D. AHRQ Conference September 27, 2010 PowerPoint PPT Presentation

  • Uploaded on
  • Presentation posted in: General

Patient-Centered Care: Improving Outcomes that Matter to Patients in the Real World. Steven S. Sharfstein, M.D. AHRQ Conference September 27, 2010.

Download Presentation

Steven S. Sharfstein, M.D. AHRQ Conference September 27, 2010

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.

- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript

Patient-Centered Care: Improving Outcomesthat Matter to Patientsin the Real World

Steven S. Sharfstein, M.D.AHRQ ConferenceSeptember 27, 2010


Mission Statement:Sheppard Pratt, a not-for-profit behavioral health system, is dedicated to the improvement of quality of life in communities by serving the behavioral health and special education needs of individuals, families, and organizations.

Sheppard Pratt

  • Served more than 57,000 individuals in 2009, including children, adolescents, and adults

  • 37 locations in 12 Maryland counties, Baltimore City, and Northern Virginia

  • Comprehensive continuum, including hospitals, residential treatment centers, psychiatric rehabilitation programs, outpatient mental health and substance abuse treatment clinics, and special education schools.

High Fidelity:

Supported employment

Assertive community treatment

Integrated dual disorders treatment

Family psycho-education

Multisystemic therapy

Seeking Fidelity: Illness Management and Recovery

Planning This Year: Permanent Supportive Housing

Evidence-supported Practice: Transition to Independence Process

Evidence-Based PracticesPsychiatric Rehabilitation Programs

Five-Year Pilot at 8 Sites in 7 Jurisdictions

Serving More than 600 Low-Income SMI/Year

Integrating Three Interventions:

EBP supported employment

Customized employment

Benefits counseling

Technical Assistance for Replication

Public-Private Partnership

Supported Employment Pilot –Components

Dartmouth College


Impact of benefits counseling

Cost-benefit analysis of state funding

Eight non-Sheppard Pratt organizations in two comparison groups

Boston University

Measuring impact of adding a vocationally-focused illness management and recovery curriculum to EBP SE

Supported Employment Pilot - Research

Challenge #1: EBPs More Expensive to Implement


More research studies should include cost-benefit analyses relative to state funding

More states should employ Maryland strategy of implementation, focusing on incentives vs. mandates

Implementing EBP in Real World -Challenges and Recommendations

Challenge #2: Difficult for Front-Line Stakeholders to Let Go of Traditional Approaches and Beliefs

Zero exclusion and rapid job search for EBP SE

Discovery process for customized employment

Implementing EBP in Real World -Challenges and Recommendations


Use independent fidelity assessment process to reinforce and inspire provider staff

States develop fidelity assessment expertise

Providers do better job of articulating interventions for families and funders

Implementing EBP in Real World -Challenges and Recommendations

Challenge #3: Tension Between EBP Integration vs. Recovery Model Consumer Choice

EBPs require integration of services, which is most effectively implemented by one provider agency

Recovery model values consumer choice of providers, which can result in multiple agencies providing one EBP

Implementing EBP in Real World -Challenges and Recommendations


Reframe choice as:

between EBP providers

between EBP and non-EBP services

Compromise where possible for certain EPBs

Coordination vs. integration

States need flexible definition of coordination

Implementing EBP in Real World -Challenges and Recommendations

There is no EBP for acute inpatient care

Need for comparative effectiveness studies

Ultra-acute care versus acute care

Hospital care versus residential diversion

A major public health issue

Final Comment

  • Login