Overview
The second chapter of the Joint Commission
on Accreditation of Healthcare Organizations'
Standards for Behavioral Health Programs
is entitled, "Provision of Care (PC)."
The goal for this function is to assure
that the processes related to the assessment,
care, discharge, or referral of the client
are appropriate and coordinated. This chapter
includes the following four core areas of
focus: 1) screening and assessment; 2) planning
care, treatment, and services; 3) providing
care, treatment, and services; and 4) coordination
of care, treatment, and services. The activities
incorporated into these four core processes
include:
- Access to the caregiving disciplines
required to effect a comprehensive treatment
plan
- Implementation of the interventions
outlined in the treatment plan to assure
client
success in the program
- Education of clients and families regarding
their care, treatment, and services
- Coordinating care, treatment, and
services for clients to achieve
successful discharge
or transfer
The key to successful implementation of
the standards in this chapter is to understand
that the integration of the core processes
and related activities represent a series
of interrelated and fluid steps in the
provision of care, treatment, and services.
Services provided should move between these
elements so that clients' needs are
met and the continuity of care is preserved.
Accreditation Requirement(s)
To conform to the provision of care standards,
the program must show evidence of the following:
- Consistent methods for conducting
comprehensive assessments are used upon
clients' entry into the program,
including:
- Emphasis on screening for substance
abuse and other addictive behaviors
- Screening for aspects of abuse
- Screening for pain
- Reassessments are conducted at
appropriate intervals, and
clients' responses
to treatment goals are reevaluated.
- Treatment plans are individualized
and continually monitored.
- Clients and their families,
if appropriate, are included
in
treatment planning
and goal setting.
- Staff members follow
interventions in an
interdisciplinary manner and communicate
effectively.
- Client needs in the
community, such as
vocational and
educational needs,
are addressed
consistently.
- Community referrals
are coordinated
and appropriate
to individual
client needs.
Sample P&Ps
This list is divided into the four major
standards categories for provision of care:
Assessment, Planning Treatment, Treatment,
and Continuum of Care.
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Implementation Tips
- Utilize objective,
standardized assessment tools for
assessment of new clients admitted to
the program.
- Assess clients for language and
cultural barriers.
- Assess for pain at every visit.
- Make sure that you have access
to interpreters for the primary
languages represented
by your client base (including
sign language interpreters).
- Be consistent with time frames
for completion of assessments.
Establish policy guideline
time frames for initial assessments
and stick
to them.
- Assure that staff members conduct
their assessments within the scope of their
own disciplines and licensure requirements.
- Have definitive policies when more
intensive assessment and evaluation is
required.
- Don't use "cookbook" treatment
plans. Each treatment plan should be clearly
individualized to each client and based
on his or her unique needs.
- Demonstrate
that the interdisciplinary team communicates
effectively about each
client's progress. This can be done
through your documentation tools, rounds,
or team conferences.
- Reassessments should take place any
time there is a change in a client's condition
or significant adjustment to his or her
treatment plan.
- Clients should
be included in the discussion about the
changes to the treatment plan.
- Have clear guidelines for staff
on how to reach consultants or clients'
primary physicians.
- Establish
clear communication channels
with primary referral sources and community
agencies that support clients' integration
into the community.
- Develop good discharge
instruction tools and follow-up mechanisms
to promote
client success.
References and Links
There are multiple resources for assessment
and treatment of OTP clients in general
and for specific client populations,
such as women and adolescents. An excellent
source is the Center for Substance Abuse
Treatment, Treatment Improvement Exchange,
www.treatment.org/index.html, which has
the following document resources:
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