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Louise Penzenstadler, Ariella Machado, Carina Soares , Yasser Khazaal

Building Bridges between inpatient and outpatient treatment settings (Transitional Case Management in addiction medicine). Louise Penzenstadler, Ariella Machado, Carina Soares , Yasser Khazaal. Disclosure. PLAN. Context in Geneva ( Switzerland ) Problem

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Louise Penzenstadler, Ariella Machado, Carina Soares , Yasser Khazaal

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  1. Building Bridges between inpatient and outpatient treatment settings (Transitional Case Management in addiction medicine) Louise Penzenstadler, Ariella Machado, Carina Soares, Yasser Khazaal

  2. Disclosure

  3. PLAN • Context in Geneva (Switzerland) • Problem • Transitional Case Management (TCM) • Results

  4. CONTEXT IN GENEVA • Canton of Geneva: population 466,158 (198,979) • Psychiatrichospital 266 beds (8 beds in outpatient setting) • Addiction hospital unit 20 beds • 2 outpatient centres 918 patients • 3 transition case managers SwissFederalStatistical Office-STAT-TAB, 2017

  5. Problem Raven et al. 2010, Pringle et al. 2006

  6. Problem In 2014: 306 patients hospitalized (524 hospitalstays/hospitalizations) 17.3% (53 patients) hospitalized≥ 3x/year Furtherdetails: 3 hospitalizations: 28 patients (9.2%) 4 hospitalizations: 9 patients (2.9%) 5 hospitalizations: 9 patients (2.9%) 6 hospitalizations: 3 patients (1.0%) 7 hospitalizations: 2 patients (0.7%) 8 hospitalizations: 2 patients (0.7%)

  7. Transitional Case Management TEAM (TCM) Indications • Patients at high risk for rehospitalization: • High service use • No outpatient care or chaotic use of outpatient care • Prevention Mas-Expósito et al. 2013, Vanderplasschen et al. 2004

  8. Transitional Case Management (TCM) 30 daysafterhospitaldischarge TCM Intervention

  9. Transitional Case Management team (tcM) • Standardizedtoolsused for: • Evaluation of problems and definition of specificneeds • Network plan • Advanced directives (Crisis management) • Co-construction of care plan for the patient’slaterdischarge Aims: • Improve transition to outpatient care and continuity of care • Reducerehospitalizations and emergency department use/visits Bonsack et al. 2009, Pomini et al. 2008

  10. 3 or more hospitalizations per year 230 patients with TCM (313 episodes of TCM) Before TCM TCM

  11. Adherence to transitional Case Management (tcM)

  12. Conclusion • Useful intervention for improvingcontinuity of care • Helpsreducerehospitalisation (phenomenon of revolving doors) in addiction treatment • High patient satisfaction as seen by treatmentadherence Furtherevaluation and long termfollow-up in progress

  13. bibliography J.L. Pringle, N.P. Emptage, and R.L. Hubbard, Unmet needs for comprehensive services in outpatient addiction treatment. Journal of substance abuse treatment 30 (2006) 183-189. M.C. Raven, E.R. Carrier, J. Lee, J.C. Billings, M. Marr, and M.N. Gourevitch, Substance use treatment barriers for patients with frequent hospital admissions. Journal of substance abuse treatment 38 (2010) 22-30. L. Mas-Expósito, J.A. Amador-Campos, J. Gómez-Benito, and L. Lalucat-Jo, Considering variables for the assignment of patients with schizophrenia to a case management programme. Community mental health journal 49 (2013) 831-840. W. Vanderplasschen, R.C. Rapp, J.R. Wolf, and E. Broekaert, The development and implementation of case management for substance use disorders in North America and Europe. Psychiatric services 55 (2004) 913-22. C. Bonsack, S. Gibellini, P. Ferrari, Y. Dorogi, C. Morgan, S. Morandi, and N. Koch, Le case management de transition: Une intervention à court terme dans la communauté après une hospitalisation psychiatrique. SchweizerArchivfürNeurologie und Psychiatrie 160 (2009) 246. V. Pomini, C. Reymond, P. Golay, S. Fernandez, and F. Grasset, ELADEB. (2008).

  14. Thankyou for your attention!Louise.E.Penzenstadler@hcuge.ch

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