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SUPERVISING PSYCHIATRIST MANUAL Download Manual
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Cover | Preface | Contents | Overview | Care Manager Role | Clinician Communications | Review Activities


REUNIONS


Purpose and Learning Objectives

The primary purpose of a reunion is to review successes with and identify barriers to sufficiently and appropriately using the Three Component Model of Respect and problem solve these barriers. Not every Health Care Organization will be able to support reunions, but doing so reinforces the educational process. Ideally reunions last 45 to 60 minutes, should involve the same clinicians who participate in the initial clinician education sessions, and should occur six to 12 weeks after the initial clinician education session. However, reunions can be of value at any time and are recommended to the extent clinicians can be encouraged and supported to attend. With respect to identifying success and barriers in implementing TCM, there are three sources of information.
1. Self-report from clinician participants

2. The patient registry and care manager supervision

3. Common issues from previous implementations

When conducting a reunion, one or a combination of these sources should be used. It is best to be prepared with all three depending on how the discussions develop. A secondary purpose of the reunion is to provide educational reinforcement, particularly around psychopharmacology. Most clinicians are interested in and appreciate this. Accordingly, reunions are primarily the responsibility of the mental health component of TCM.
When conducting a reunion, one or a combination of these sources should be used. It is best to be prepared with all three depending on how the discussions develop.

A secondary purpose of the reunion is to provide educational reinforcement, particularly around psychopharmacology. Most clinicians are interested in and appreciate this. Accordingly, reunions are primarily the responsibility of the mental health component of TCM.

Review TCM Experiences: Three Alternative Approaches

Alternative 1: General Approach:
Ask participants to talk about successes and problems. A helpful method is to use a flip chart or chalk board to record items. Assign one member to record while you facilitate may make leading the session easier and more interactive. After general discussion, focus in on specific problems, which ideally you have identified before the reunion meeting, e.g. see data below. If participants are hesitant, then you might go around the room asking each in turn. When barriers are identified, encourage sharing of solutions to significant problems that seem to have practical solutions.

Alternative 2: Specific Topics Approach:
As an alternative to open ended discussion, some psychiatrists have found it easier to discuss the following specific topics which are generalizable to most primary care settings.

1. Patient Participation
Are patients receptive? Any complaints? Are you keeping track of numbers and reasons why patients refuse care management? Any comments about drop-outs?

2. Care Manager
How is communication? Are you receiving timely contact information?

3. Psychiatric Supervision / interface
Are you receiving any suggestions? Are they helpful? Have you asked for informal consultation? Why? Why not?

4. Paper work
How difficult is it? Is it taking up too much time? Is it getting easier? Overall, does the system make it easier to do depression care?

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