Process - Physician - Fraser Health Authority

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Collaborative Care Process Map-Episode of Care for MHSU Clients Referred by PCPs (Primary Care Providers)[DRAFT VERSION 11] Mar 8, 2012ReferralIntakeOngoing TreatmentDischarge/TransitionReferral to RapidAccess Clinic (RAC)for Psych ConsultReferral to MentalHealth &Substance Use(MHSU) CentreCommunityMHSU ServicesReferral FormReasons for Referral:non-urgent psychiatrist referralpsychiatric assessmentCrisis interventionShort term stabilizationAccess to therapy (i.e. groups)Intake assessmentCase consultationCase managementReferral to community servicesSubstance Use servicesOutreachEarly psychosis InterventionReferral pre-registered /loggedby MHSU admin staffReferral screened /triagedby MHSU clinicianPCP receivesconfirmation of receiptof referral request byphone call or letter fromclinician within 5business days indicatingdisposition of referral.When possible, face toface meeting arrangedwith client &/or GP.Unsuitable Client:Recommendationto appropriateservicesSuitable Client:Assigned toMHSU team orRACReferral to otherresourcesPsychiatrist Assessmentand Treatment Plan /RecommendationsCopy of Assessmentand Treatment PlanLetteracknowledgingreceipt of referraland indicatingdisposition ofreferral and type ofservice offered (ieface to face, phonecall, etc)Ongoing TreatmentConsult ReportPCP/Clinician maycontact psychiatrist byphone for follow upquestions/advice (seeVIHA protocol)Case review Q6 months(documented on RecoveryPlan Review)Copy of Recovery PlanReviewUnplannedDischarge:Outreach visit orletter sent due toloss of contactPlanned Discharge:If end of treatment,client relocates toanother community, etc.then PCP alerted via p/cletter or fax requestingconsultationPreparing for discharge:Pre-Discharge meetingconsultation with PCPDischarge Planning –Plan transition back toPCP careFile keptpending up to 1month’s timeLetter or phonecall to PCP forplan of actionTermination SummaryInclude name and phone number ofperson for PCP to contact for questionsor advice if neededCopy of Termination SummaryAfter Discharge:Follow-up with PCP & patient in 1 month’stime (file left pending at times or closed inconsultation with PCPNote:Community Patient Conferencing Fees: 14016 and 14046 Compensates GP whenconferencing for the creation of a coordinated clinical action plan for patients living in thecommunIty or facility based, with more complex needs, including patients with mentalhealth conditions. The following codes may be utilized at various points in the episode ofcare for MHSU patients:GP MentalHealthPlanning Fee14043CounselingVisits:Fee code 14044,14045, 14046, -14048GP CommunityPatientConferencing Fee14016GP Telephone/Email follow upManagement fee14079
Fax requests in Victoria to 250 405-3605 or, from elsewhere in BC, to 1-800-609-4884 (toll free).OR mail requests to: PharmaCare, Box 9652 Stn Prov Govt, Victoria, BC V8W 9P4section 1 – prescriber informationname & mailing address mail confirmationpharmacarespecial authority requestThis facsimile is Doctor-Patient privileged and contains confidential information intended only for PharmaCare. Any other distribution, copying or disclosure is strictly prohibited.If you have received this fax in error, please write “MIS-DIRECTED” across the front of the form and fax toll-free to 1 800 609-4884, then destroy the pages received in error.Use this form to request: • Exemptions to the Reference Drug Program (RDP)• Exemptions to the Low-Cost Alternative Program (LCA)• Limited Coverage Drugs (Please see step 4 on reverse)application dateForms with information missingwill be returned for completion.Should approval be granted for this Special Authority request, PharmaCare’s authorization is solely for the purpose of providing prescription benefit for the cost of the requestedmedication. PharmaCare makes no representation about the suitability of the requested medication for the patient’s, or any other, medical condition or problem.Please see reverse for category definitions and instructions on completing this form.yyyy mm dd area codePrescriber’s telephone #Prescriber’s college ID #Prescriber’s fax #area codesection 2 – patient informationpersonal health number (PHN)patient (family) namedate of birth (YYYY / mm / DD)patient (given) name(s)section 3 – Medication detail informationrequested drug exemption (indicate both medication and dosage requested) new Request renewalindication(s) for special authorityTreatment Failure on Reference Drug /Low-Cost Alternative / First-Line Agent(please list medications tried)Adverse Reaction to Reference Drug /Low-Cost Alternative / First-Line Agent (please listmedications tried and specify adverse reaction)Drug / Drug Interaction with Reference Drugor First-Line Agent (please list both drugs thatmay interact)Diagnosis and other patient-specific indicatorsPersonal information on this form is collected for the operations of the Ministry of Health. The Ministry will use the information in the decision to provide PharmaCare benefits for themedication requested, and for implementation, monitoring and evaluation of this and other Ministry programs, and for the management and planning of the health system generally.Personal information will be used and disclosed in accordance with the privacy protection provisions of the Freedom of Information and Protection of Privacy Act. If you have anyquestions about the collection of this information, call Health Insurance BC from Vancouver at 1-604-683-7151 or from elsewhere in BC toll free at 1-800-663-7100 and ask to consulta pharmacist concerning the Special Authority process.I have discussed with the patient the purpose of the release of the patient’s information to PharmaCare to obtain Special Authority forprescription benefit and for the purposes set out above.Presciber’s Signature (Mandatory)PharmaCare may request additional documentation to support this Special Authority request.Patient Signature (Optional)pharmacare use onlyeffective dateYYYY / MM / DDDuration of therapy /termination dateYYYY / MM / DDHLTH 5328 Rev. 2010/03/02
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SteppedCareLevel 1PSP Mental Health
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Fold back this page before administ
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CBISCOGNITIVE BEHAVIOURAL INTERPERS
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Table of ContentsINTRODUCTION. . .
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IntroductionThe following modules h
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TipsTeachingSelling Strategies• E
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Flow ChartsThis module contains flo
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Patient NeedsTryThe Circle of Depre
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AnxiousSymptomsTryOverwhelmedChaoti
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Assessment ModuleThe Assessment Mod
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5 Energy levela. How would you rate
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15 Phobiasa. Any unrealistic or exc
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21 CAGEHow many drinks might you ha
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DIAGNOSTIC SCREENING WORKSHEET (CON
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Problem List Action PlanACTIVATIONR
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Self-Assessment QuestionnaireName:
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Self-Assessment ProfilePleaser: Hig
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Self-Assessment ProfileOver-Thinker
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Understanding Depression- Frequentl
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Depression: System-Wide CrashDepres
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Activation ModuleThe Activation Mod
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Depression’s Energy BudgetEvery d
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Small GoalsThe concentration, fatig
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Problem SolvingDepression can make
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Chunk the DayStrategies that give p
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Appreciation Exercise“Good for Me
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The Circle of DepressionCognitive-b
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Common Thinking ErrorsThe situation
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THOUGHT CHANGE PROCESS (CONTINUED)T
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Thought StoppingDepression often ma
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Good Guilt / Bad GuiltA world witho
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Setting LimitsMost of us like to be
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Is Anger a Problem for You?Tom arri
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Stress ResponseIntroduction to Rela
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Variation - Box BreathingABDOMINAL
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Body ScanPurpose• Body scan is a
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Stress BustersPurpose• Shorter te
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MindfulnessPurpose• Mindfulness i
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BreathMINDFULNESS MEDITATION (CONTI
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Healthy Habits for SleepingDepressi
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IT’S TRUE: YOU ARE WHAT YOU EAT!
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The Wellness WheelPHYSICALGROWTHSEL
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CBISCognitive Behavioural Interpers
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FLOW CHARTS……………………
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PANIC DISORDER• Anxiety “System
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The Many Faces of AnxietyPanic Diso
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Medical ConsiderationsMost Common M
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Anxiety“System-Wide Explosion”A
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Resources for Self-HelpOnline Resou
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GAD: Self-Assessment QuestionnaireN
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GAD: Self-Assessment ProfileHard Dr
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How Anxiety WorksTHOUGHTSBODYFEELIN
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Panic CircleEvent (public speaking)
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Your Emotional Thermometer• Imagi
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Anxiety EquationAnxiety arises out
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2. When something bad happens, I wo
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Coping CardsAnxious people often ma
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Problem SolvingAnxiety is strengthe
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Example: Kelly begins by making a l
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D.E.S.C. ScriptAssertiveness doesn
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Application forPsychiatric Medicati
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APPENDIX 2: WOMEN’S MENTAL HEALTH
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Pharmacotherapy in the Perinatal Pe
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FAMILY PHYSICIAN GUIDE | ADDRESSING
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Olanzapine (Zyprexa)Tablets, wafers
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Consortium forOrganizationalMentalH
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3. Gather details on current andpre
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Task Two: ADVISE1. Provide meaning
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SUPPORTED SELF‐MANAGEMENT FOR DEP
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TABLE OF CONTENTSIntroduction 1What
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INTRODUCTIONTake a moment now to as
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WHAT IS DEPRESSION?The two most com
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WHAT CAUSES DEPRESSION?People becom
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WHAT CAUSES DEPRESSION?ThoughtsEach
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WHAT CAUSES DEPRESSION?EmotionDepre
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WHAT CAUSES DEPRESSION?ActionDepres
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WHAT CAN YOU DO ABOUT DEPRESSION?MI
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MORE ABOUT MEDICATIONMedication is
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ANTIDEPRESSANT SKILLSIn this sectio
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REACTIVATING YOUR LIFEStep 1: Ident
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REACTIVATING YOUR LIFESmall DutiesE
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REACTIVATING YOUR LIFEStep 2: Choos
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REACTIVATING YOUR LIFEStep 3: Set r
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REACTIVATING YOUR LIFEStep 4: Carry
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THINKING REALISTICALLYNegatively di
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THINKING REALISTICALLYStep 1: Learn
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THINKING REALISTICALLYStep 4: Pract
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SOLVING PROBLEMS EFFECTIVELYStep 1:
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REDUCING THE RISK OF RELAPSEPlan ah
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Congratulations! You have now made
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SUGGESTED READINGON DEPRESSION AND
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DIETThe Canada Food GuideGuidelines
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SLEEPStress, anxiety, and depressio
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CAFFEINECaffeine stimulates the sym
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CHALLENGING DEPRESSIVE THOUGHTSSitu
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PROBLEM SOLVINGACTION ADVANTAGES DI
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AnxietyDementiaDementiaBipolar155
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Practice Support ProgramGeneralized
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Montreal Cognitive Assessment(MoCA)
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Serial 7s: Administration: The exam
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Appendix CNAME OF PATIENTStandardiz
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Item 11Scoring WORLD backwards (ins
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Appendix CStandardized Mini Mental
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SCORING THE MOOD DISORDERQUESTIONNA
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FORM 4MENTAL HEALTH ACT[ Sections 2
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CommunityMHSU ReferralFormBounceBac
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REFERRAL FORMMental Health and Subs
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MENTAL HEALTH AFTER HOURSPLEASE LEA
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DOCUMENTATION REQUIRED UPON REFERRA
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Adult Eating Disorders ProgramRefer
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Medical History:Medical causes of l
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Who Are We?This is a specialized pr
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Page 250 and 251: Fraser East:This program is part of
Page 252 and 253: Fact SheetPanic Disorder GroupDoes
Page 254 and 255: Fact SheetGeneralized Anxiety Group
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Page 258 and 259: Early Psychosis Intervention Progra
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Page 262 and 263: Mental Healthand Addiction… suppo
Page 264 and 265: Fraser Health Mental Healthand Addi
Page 266 and 267: ADDICTION SERVICESAddiction Service
Page 268 and 269: ADDICTION SERVICESYouth Addictions
Page 270 and 271: ADDICTION SERVICES6. Long-term Resi
Page 272 and 273: MENTAL HEALTH SERVICESMental Health
Page 274 and 275: MENTAL HEALTH SERVICESDelta Mental
Page 276 and 277: MENTAL HEALTH SERVICES4. Community
Page 278 and 279: MENTAL HEALTH SERVICESMinistry of E
Page 280 and 281: MENTAL HEALTH SERVICES7. Residentia
Page 282 and 283: Mental Health & AddictionsHEALTHY L
Page 284 and 285: Client name: ______________________
Page 286 and 287: Client name: ______________________
Page 288 and 289: Taking Wellness to Heart! Metabolic
Page 290 and 291: Mental Health and Substance Use Rev
Page 294: Fax the Special Authority Request t
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Process - Physician - Fraser Health Authority

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