Keywords: care management, quality improvement, change
In order to implement a Quality Improvement (QI)/Care Management Model, the challenge of managing change will require strategic planning. According to Kotter, numerous studies in the last ten years confirmed 60-80% of change projects objectives were not achieved or the projects were not completed timely or on budget (2009). The ability to manage change will rely on the success of the organization and the success of the healthcare leaders to understand and implement change management principles. The effectiveness of this quality improvement project will require changes in the organization’s culture and infrastructure to overcome barriers and work toward quality improvement. Kotter’s eight step approach supports the move. It adds a sense of urgency, enables building coalitions, and creates a vision for the organization (Kotter International, 2012).
Health care delivery systems have provided patients fragmented care for years. Individuals with a complexity of medical problems find themselves with multiply physicians, which can result in a duplicate of services or an increase of cost to both the patient and organization. Patients are also exposed to safety issues such drug interactions from various providers. Over the years, care management has become an important entity of the health care system. One of the main purposes of care management is to focus on diseases that are high cost or have a potential for complications or diseases if not closely monitored. This paper will focus on the Kotter’s Model and operative strategic planning of a quality improvement (QI) team, to bring about a transformation within the health care system. The project will implement a mental health collaborative care management (MHCCM) team to manage the care of patients with a chronic mental illness (CMI) and medical comorbidities.
There are more than 450 million people living with mental illness. Epidemiology research reveals that individuals with a mental disorder are at risk for developing a chronic condition and those diagnosed with schizophrenia or bipolar disorder are up to three times more likely to develop three or more chronic conditions and subsequent mortality (Druss & Walker, 2011). One study reveals that the highest at risk group for mortality includes the severe mentally ill individual under the age of forty-five. Chronic mental illness with comorbidity can result in medical noncompliance, increase disability and mortality and higher health costs. The CMI are entitled to holistic care just as every other patient does. These patients should receive services that are effective, humane, treatments to decrease or avoid chronic disability, and early death. Patients faced with mental illnesses also have to deal with negative stigmas, rights being violated, neglected in the health care systems, and discrimination. They should also receive care that offers support to head them to healthier and richer lives.
“Comorbid mental disorders are under recognized and not always effectively treated”, (World Health Organization, 20013, p. 10). It is now time to tackle these