1. Choosing a Case

A. Look at your caseload in the registry. It can be helpful to think about someone on your caseload who isn’t improving. Think about factors that may influence this lack of progress.

Find a factor that you can change soon, like:

  1. Patient who often has no-shows
  2. Consider telephone contacts
  3. No consults or infrequent consults about patient
  4. Consult now on this patient, no need to wait until 8 weeks
  5. No treatment changes after consults
  6. Talk this over with team and consultant – decide on a date to have another consult if no changes occur
  7. Patient who has been doing a therapy for 6-8 sessions and isn’t having solid improvement
  8. Consider a treatment change
  9. Patient who has stayed on the same or low dose of medication without improvement
  10. Can bring a case where you cannot see a pattern to the problem – it is recommended that you do a consult on this case before bringing this case to the call

OR

B. Look at your caseload report overall and see if there is a pattern you want to change

  1. PHQ-9 not done consistently
  2. Little or no contact with CBO or PC
  3. High numbers of no-shows
  4. Few telephone contacts; percentage of phone to in-person less than 25% telephone

2. Prepare Case Presentation

A. Complete the following for the patient you’ve chosen. If you chose an overall pattern then be prepared to answer the last three questions.

Age:

Gender:

Diagnoses:

Basic demographic info (no PHI or information that could inadvertently identify a patient - please!).For example, living situation, stressors, strengths, factors affecting treatment course / outcome.

PHQ-9 at Baseline:

Most recent PHQ-9:

Length of time in treatment (# weeks or months):

Number of contacts:

Answer these questions as much as you can and we can discuss on the call.

What factor did you identify?

What changes did you institute?

How is the patient responding?

B. If you found a pattern—answer the questions that you can and we can discuss options on the call.

What is the pattern?

How did you recognize the pattern through the registry?

What do you think the factors are behind the pattern?

What will you start doing to change the pattern?