The Access Initiative: Improving Appropriateness of Patient Fit for Resident Case Assignment

• Published in: Academic psychiatry Vol. 40; no. 4; pp. 620 - 622
• Main Authors: Nay, William T., Urbach, John R., Maixner, William D., Hostetter, Emily, Waller, Susan J.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-08-2016; Springer Nature B.V
• Subjects: Ambulatory Care Facilities; Clinics; Column: Educational Case Report; Community Relations; Community Resources; Education, Medical, Graduate; Geriatrics; Group therapy; Group Unity; Health services; Health Services Accessibility; Humans; Indigent care; Internship and Residency; Medical Education; Medicine; Medicine & Public Health; Mental health care; Mental Health Programs; Mindfulness; Modeling (Psychology); Nurses; Patients; Psychiatric Services; Psychiatry; Psychiatry - education; Psychotherapy; Psychotherapy - education; Relaxation Training; Resistance (Psychology); Safety-net Providers; Scheduling; Schizophrenia; Social Work; Social workers; Substance abuse treatment; Teaching Methods; Training Objectives; Triage - methods; Virginia; Waiting Lists; Workload; United States > US; Virginia; General Psychiatry Clinics; Virginia Commonwealth University Health System (VCUHS); Psychotherapy Case; Medication Management Appointments; Group Access
• ISSN: 1042-9670; 1545-7230
• DOI: 10.1007/s40596-015-0441-7

The Virginia Commonwealth University Health System (VCUHS) is an inner-city hospital complex that serves as a “safety net hospital” for a challenging mix of patients and clinical needs. Due to high demand and limited community resources for mental health services, wait times have historically been as long as six months in our clinic. Informed consent, group rules, and rationale for the Access Program, all with written handout material; patient introductions and brief survey of presenting complaints; psychoeducational material and discussion of mental health treatment generally; and specific discussion of the volume and needs of our outpatient populations, as well as resources in our clinic. Relaxation training; psychoeducation on the methods and goals of mental health treatment with an emphasis on improvement; description of various mental health services, those in our clinic and those not available in our clinic; and initial work with patients in writing objectively their presenting problems and treatment goals.