To Infinity and Beyond... in an Hour: Advanced Strategies to Expand Clinical Programs in CL. (Co-sponsored by the Division Director’s SIG and Business of CL Subcommittee)

Abstract: Many CL psychiatrists with innovative ideas become stymied by administrative barriers when trying to expand beyond traditional reactive CL services. Those who do succeed in launching new initiatives often face additional hurdles to sustainably maintain them in the long-term. These systemic impediments are especially harmful given that these initiatives often address crucial drivers of healthcare inequity and disenfranchisement.

Whether in an independent community hospital or large academic center, a facile understanding of clinical operations can inform responsible and sustainable growth strategies that maximize value without compromising service quality. Such strategies include crafting a cohesive narrative that strengthens the business case with added value, aligns with institutional strategic and operational priorities, and connects emotionally and logically with all stakeholders.

In this session, we will discuss advanced strategies that CL psychiatrists can use to successfully develop, grow, and even salvage, innovative and integrative CL programs.

Dr. Stephanie Cho will discuss the importance of "measuring what matters" by identifying the metrics that align with decision-makers' priorities while recognizing what is within a CL service's control. She will demonstrate the power in creating narratives that weave together quantitative data with intangible benefits and differentiators that a service can provide. (10 min)

Dr. Carlos Fernandez-Robles will discuss the concept of “responsible growth” and the use of forecasting both to demonstrate consequences of maintaining status quo and to avoid unsustainable growth. He will also discuss approaches to mitigate harm and protect future growth opportunities in the event of unsustainable expansion. (15 min)

Dr. Brian Bronson will present original national-level survey data on interdisciplinary CL staffing patterns at 49 institutions. This will be followed by a case study of successful services expansion at his own institution, a 650-bed academic regional referral center, from an under-staffed, reactive CL psychiatry teaching service, to a robust program that includes CL psychiatrists, social workers, psychologists, nurses, physician assistants, addiction counselors, and a crisis prevention team. (15 min)

Although we often think of CL psychiatry from the inpatient perspective, there is rapidly growing need and appreciation for CL psychiatrists in outpatient settings, particularly in working with patients with complex medical needs and comorbid mental health challenges who often fall through the cracks of our modern medical system. Dr. Kaleena Chilcote will discuss unique challenges and opportunities in navigating outpatient program growth and development, including what is known in current literature and what she has learned from personal experience as director of psycho-oncology services in multiple large academic centers. (15 min)

The remaining time (20 min) will be reserved for discussion as per audience’s preference. Options will include facilitated group discussions of current administrative challenges shared by participants, ultra-brief vignettes prepared by the speakers, or direct Q&A with speakers.