American Hospital Association Special Conference Call How Johns Hopkins Became and Remains a High-Quality Psychiatric Provider Presented by: J. Raymond.

American Hospital AssociationSpecial Conference CallHow Johns Hopkins Became and Remains a High-Quality Psychiatric Provider

Presented by: J. Raymond DePaulo, M.D. and Anita Everett, M.D.

Observations of a Relative Newcomer

Anita Everett, MD

Section Chief

Community and General Psychiatry

The Johns Hopkins Bayview Medical Center

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Organizing Elements

Patients

Faculty and Staff

Administrative System

Community Connection

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PATIENTS

Primary, secondary, tertiary care

Institutional commitment to uninsuredand complex patients

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FACULTY and STAFF

Nursing – respected as professionals

Medical

National and international experts AND grounded in shared institutional vision

Attitude of active participation in regulatory necessities (View compliance as part of supporting the institution)

Salaried (supports value for all patients)

Embrace clinical challenges and complex problem-solving

Respect for decisions administration makes

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ADMINISTRATIVE SYSTEM

Shared vision and commitment to support of clinical mission as well as teaching and education

Shared vision regarding the place/position of the institution

Institution-wide spirit of cooperation in terms of clinical care, research and teaching.

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COMMUNITY CONNECTION

Maintain good working relationships with state mental health department and other decision-makers in the services system

Support of faculty holding organizational leadership roles that increase JHU visibility

Hospital generally does a great deal of local community stewardship

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Thoughts from a Career at Johns Hopkins

J. Raymond DePaulo, M.D.

Chairman, Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine

Psychiatrist-in-Chief, The Johns Hopkins Hospital

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Outline

Historical Foundations

Culture of Faculty and Staff

Policies and Procedures

Vision of the Future

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Our Founding Mission

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The Aims of a Psychiatric Clinic - Adolf Meyer, 1913

“…a psychiatric clinic, therefore, is a hospital for teaching as well as for treatment and study of mental disorder.”

“I should like to see a clinic give one half of its beds to intensive work on a limited district and bestow the other half on intensive work on special clinical problems…”

With this vision he founded one of the first psychiatric clinics to be fully integratedinto academic medicine.

Historical Foundations

Mission-driven

- Comprehensive care for the community

- Treat the most difficult cases in areas of our expertise

Trained generations of physician/psychiatrists using an

explicitly pluralistic, multidisciplinary approach to patients with

a variety of problems

Taught concepts of disease, temperment, behavior, and

narratives (McHugh and Slavney) that built on Adolf Meyer’s

approach to care of the whole person

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Culture of Faculty and Staff

Clinical work, research, and education are all mutually supportive activities. All clinically trained faculty do clinical work in a teaching setting.

Research mission does not drive educational or clinical work. In fact, opposite is true.

Culture of collaboration and integration across disciplines, divisions, departments and schools.

Because we treat the most complex patients, we have unique experience that continually reinforces expertise.

Commitment to excellence in everyday clinical issues in community patients

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Policies and Procedures

The core mission of patient care drives our policy decisions.

We look for opportunities to subjugate financial and regulatory burdens to models of care rather than the reverse.

The organization of our inpatient units helps to produce not only good care but also models of patient care

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Disease Burden by Illness - DALYHigh Income Countries | All Ages | 2004

DALY = Disability-Adjusted Life Year (measures healthy life years loss to premature death and disability)

Source: World Health Organization – Burden of Disease Statistics, 2004

0 2 4 6 8 10

Unipolar depressive disorders

Ischaemic heart disease

Cerebrovascular disease

Alzheimer's and other dementias

Alcohol use disorder

Hearing loss, adult onset

Chronic obstructive pulmonary …

Diabetes mellitus

Trachea, bronchus, lung cancers

Road traffic accidents

% of total DALYs

15.2%

Vision for the FutureOur current work and initiatives fall into three major themes:

TRANSLATION | Translational Centers in Major Psychiatric Diseases

To accelerate translation of genetic and molecular discoveries into rational treatments and accessible models of care for major psychiatric diseases: mood disorders, memory disorders, anxiety disorders, schizophrenia, and autism.

PREVENTION | Center for Behavior in Medicine

To draw on our expertise in addictions and eating disorders to create prevention strategies for some of the most common and costly medical conditions: obesity, diabetes, heart disease, cancer, HIV.

DRUGS AND BEHAVIOR | Center for Substance Abuse Research and Treatment

To bring our models of patient care, based on decades of pioneering research on the treatment of opioid dependence to a broader audience

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Vision for the Future Mental Illness in the 21st century

New molecular methods – genomics and epigenetics – as well as brain imaging, will produce new ways to interrogate the brain to help explain disease mechanisms.

Translating this knowledge will enable surer and faster diagnosis and lead to treatments that are rational and more effective.

Understanding these disorders will change fundamentally the experience of patients and families.

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Summary

Our history provides continuityand comprehensivenessin patient care

Our faculty and staff are mission-driven

Our mission and science drive policies

Research will guide improvements to patient care

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Thank You

We are happy to answer questions:

J. Raymond DePaulo, M.D.

Anita Everett, M.D.Beth Ambinder, BSN, MBA

AdministratorDepartment of Psychiatry and Behavioral Science

www.hopkinsmedicine.org/psychiatry18