Despite the need for rational system level planning in public sector programs, there is a dearth of planning tools that support decision-making, hindering efforts of state mental health agencies to reform the system to be more responsive to client needs. The objective of this project is to assist mental health planners in improving system performance to increase timely transitions of individuals to appropriate levels of care using state of the art modeling techniques. In this project, a multidisciplinary research team will collaborate with public mental health administrators in Philadelphia and Delaware on enhancements to a decision support model developed in a previously funded R21 exploratory project. A core component of a planning tool is a client flow simulation model that represents client transitions in, through, and out of the hospital and residential system. The hospital and residential system is conceptualized as a continuum of care beginning with the most intensive acute hospital care to the least intensive supported housing. Delaying clients from admission to appropriate levels of care has clinical, economic and legal consequences. The way in which resource constraints cause such delays, i.e., waiting for transition to appropriate levels of care, is the central issue dealt with in the model. In our previous client flow model, we demonstrated that by solving a bedblocking problem in residential facilities we could reduce congestion in the most intensive care facility, i.e. hospital.
The specific aims of this project are: 1) to enhance the client flow simulation model using needs based transition rates and the incorporation of effects of intensive case management services;2) to demonstrate feasibility and applicability of the simulation modeling approach for decision support by replicating the model development process in another site, and 3) to explore methods and tools to disseminate the model based planning approach to many other state/local mental health authorities by creating a menu driven web based application that can be customized to other sites.
| Pellowski, Jennifer A; Kalichman, Seth C; Grebler, Tamar (2016) Optimal Treatment Adherence Counseling Outcomes for People Living with HIV and Limited Health Literacy. Behav Med 42:39-47 |
