Seattle University Collaborative Projects - International Academy of ...

Dalkilic (2008) in their review of eight RCTs and 66 case reports found no empirical basis forgeneral recommendations regarding the use of particular types of polypharmacy. Mindful of thelikelihood of psychotropic abuse or diversion in a correctional facility, our team at the FresnoCounty Jail instituted a program to improve diagnostic practice, and decrease the possibility ofabuse/diversion of medications. Five specific medications were progressively phased out of theformulary from August 2007 through November 2007. Medications required but not on theformulary were still available using a non-formulary request process. Evaluations werecomprehensive, and included a consideration of malingering in all cases. Staff from a variety ofdisciplines were educated about the program. After an initial increase in requests for mentalhealth services, there were no untoward incidents or adverse outcomes in the long-term. In 2011,we systematically analyzed available data to see what the impact of the changes were, in aretrospective study design. The variables looked at were ones that reflected clinical status, crisiscalls, safety cell placements, and hospitalization (involuntary holds) but that Management had nodirect control over. The findings and implications resulted in substantial savings for thecorrectional facility without compromising quality of care and will be discussed in greater detailduring the presentation.Patient Satisfaction, Costs and OutcomesRaju Paturi, Illinois Department of Corrections, Springfield, USA (drrajupaturi@yahoo.com)Physicians generally try to keep their patients happy, if possible, with the notion that patientsatisfaction can further enhance better clinical outcomes. There have been several recent studieslooking at the treatment outcomes in different disciplines to systematically look at the clinicalimpact of patient satisfaction. Interestingly, however, traditional thinking has not been borne out- whether or not patient satisfaction is a focus of treatment, clinical outcomes have been seen tobe comparable. However, the impact of patient satisfaction appears to be evident in significantlyincreased costs associated with this population. In addition, there is a huge economic burdenassociated with health care fraud in the United States (in 1995, it was to the tune of about 15billion dollars). The overall economic impact of both these phenomena, as they relate to mentalhealth treatment, will be discussed in further detail during the presentation.A Summary of the Evidence for PsychiatryJagannathan Srinivasaraghavan, Southern Illinois School of Medicine (jagvan@gmail.com)There is an enormous need for the profession to sit up and take notice - we are at the crossroads,and the direction we take will decide the future of Psychiatry. The global community does nothave unlimited financial resources, and we are all required to follow the utilitarian principle - thegreatest good for the greatest number. Unfortunately, we are besieged by various influences -legal, political, corporate and economic. The Choosing Wisely movement is a timely63