Clinical Innovations Highlighted
Clinician Educator Showcase Plenary
Highlights Clinical Innovations
Drs. Rasim Diler, LalithKumar Solai, Christopher Dobbelstein, Robert Hudak and Julie Kmiec
field questions during a panel discussion at the 2013 Clinician Educator Showcase
Collaboration between Department of Psychiatry clinician educators in the early stages of their careers and their experienced mentors is critical to the ongoing development and implementation of innovative practices in the clinical programs at Western Psychiatric Institute and Clinic of UPMC (WPIC). The 2013 Clinician Educator Showcase highlighted the following five of the many clinical innovations resulting from these collaborative relationships as part of the plenary session before an audience of over 170 participants.
Bridging Clinical Innovation with Evidence-based Medicine: Inpatient Child and Adolescent Bipolar Services (In-CABS). Rasim Diler, MD, Assistant Professor of Psychiatry and Medical Director of the In-CABS unit, provided an overview of the In CABS unit, which utilizes an integrated, evidence-based/guided model of assessment and treatment of youth with (and at-risk-for) bipolar disorder spectrum disorder. Dr. Diler reviewed some of the challenges, obstacles/resources, surprises, and successful outcomes that he and Dr. Boris Birmaher, Endowed Chair in Early Onset Bipolar Disease and Professor of Psychiatry and Director of Child and Adolescent Bipolar Disorders Services, encountered while establishing this protocol-driven program that bridges clinical-research services and inpatient-outpatient care. The In-CABS unit is the nation's first inpatient facility for diagnosing and treating bipolar disorder in children, and has been recognized for its novel and effective patient care through the receipt of several honors including awards from the Hospital Association of Pennsylvania (2011), the National Council for Community Behavioral Healthcare (2013), and the Pennsylvania Rehabilitation and Providers Association (2013).
Improving Quality of Care for Obsessive Compulsive Disorder (OCD). Robert Hudak, MD, Assistant Professor of Psychiatry and Medical Director of the Center for Treatment of Obsessive Compulsive Disorders at WPIC, has established specific protocols for medication use to ensure optimal medical treatment for patients in the OCD Intensive Outpatient Program. Through the efforts of Dr. Hudak and his mentor, Mary Phillips, MD, Professor of Psychiatry and Clinical and Translational Science, the Center has earned a reputation as one of the few major metropolitan areas in the United States that offer adequate treatment for OCD. Dr. Hudak has established community ties and participated in community outreach to help spread awareness and understanding of OCD, and to ensure that people with the illness know that treatment is available for this disorder.
Acceptance of HIV Testing in an Ambulatory Detoxification Setting. In 2006, the Center for Disease Control recommended that populations at high risk for HIV be tested annually and that barriers to testing should be reduced. In response to the Center’s recommendations, Julie Kmiec, DO, Clinical Assistant Professor of Psychiatry, consulted extensively with Antoine Douaihy, MD, Medical Director for the Center for Psychiatric and Chemical Dependency Services, to implement rapid HIV testing at the Ambulatory Detoxification Program. Approximately 70% of patients in the program accepted HIV testing. As part of their evaluation of this quality improvement initiative, Drs. Kmiec and Douaihy found no significant differences in acceptance of HIV testing by patients based on the substance for which they were seeking treatment, and they plan to explore other clinical and research questions as part of this ongoing initiative.
Exploring the Role of the Psychiatrist in Improving the Physical Health of Patients with Serious Mental Illness. Christopher Dobbelstein, MD, Assistant Professor of Psychiatry and Medical Director of the WPIC Outpatient Primary Care program, noted that individuals with serious mental illness (SMI) die 15-20 years earlier than those without SMI. The medical literature suggested that modification of risk factors can likely improve the physical health of individuals with SMI, so Dr. Dobbelstein and his mentor, Frank Ghinassi, PhD, Associate Professor of Psychiatry and Vice President of Quality and Clinical Improvement at WPIC, have been exploring the optimal role of psychiatrists in improving the physical health of their patients. Dr. Dobbelstein conducted a retrospective chart review that revealed that psychiatrists’ responses to notification of their patients’ unhealthy measures were heterogeneous, indicating the need for active dialogue and new models of care. Through his work, Dr. Dobbelstein has assembled a collection of resources that other clinician educators may utilize to learn more about this important topic.
Managing Behavioral Disturbances of Dementia in Long-Term Care. LalithKumar Solai, MD, Assistant Professor of Psychiatry and Medical Director of Geriatric Services at WPIC, saw a need to better educate staff in nursing homes caring for residents diagnosed with dementia. Dr. Solai consulted his mentor, Charles F. Reynolds, III, MD, an internationally recognized expert in geriatric psychiatry and UPMC Endowed Professor of Geriatric Psychiatry, about how to develop and implement a multi-disciplinary team approach to managing complex behavioral issues in patients with dementia. This approach has been implemented through training of staff at the Kane Regional Center Behavioral Unit with notable improvements in outcomes and staff engagement.