Research

Judith Storfjell, PhD, RN, Funded Projects

Integrated Health Care Without Walls

Funding Source: Health Resources and Services Administration

Dates: 7/1/07 – 6/30/12

Co-Investigators: Marsha Snyder, Judy McDevitt, Sheryl Stogis

Abstract: Integrated Health Care (IHC) is a nurse-managed center of the College of Nursing (CON), University of Illinois at Chicago (UIC) through which UIC faculty family nurse practitioners and mental health clinical nurse specialists, provide integrated primary physical and mental healthcare services for people with serious mental illness (SMI) such as schizophrenia, bipolar disorder, or major depression and with or at risk for co-morbid chronic physical disease in partnership with Thresholds, the leading interdisciplinary freestanding psychiatric rehabilitation agency with locations throughout metropolitan Chicago. In spite of the fact that IHC has grown to four clinic sites located in or near these psychiatric rehabilitation centers, services remain inaccessible for one group of Thresholds clients (called members)—those who are homebound and socially isolated by limitations due their serious mental and physical illnesses—many of whom live in group homes or geographically clustered housing units.

The purpose of this proposed project is to dramatically increase access to integrated health care services in order to improve health outcomes for these vulnerable, hard-to-reach Thresholds members through an innovative combination of outreach strategies to include: a) house calls, b) group visits, and c) telemonitoring—called IHC Without Walls (IHC WOW). We will broaden our award winning, evidence-based clinic model by linking these new components to our existing clinic services.

As an academic nursing practice, we view IHC WOW as an opportunity to integrate teaching and evidence-based practice; accordingly our objectives include expansion of novice and advanced practice experiential learning within this innovative practice domain. Specific project objectives include 1) increasing access to quality, cost-effective integrated primary and mental health care for a total of 450-500 hard-to-reach Thresholds members using house calls (decrease barriers to healthcare and health disparities); 2) delivering tailored interventions during group visits complemented by home telemonitoring to improve therapy adherence and clinical outcomes; and 3) expanding nursing faculty knowledge and practice and structured pre-licensure and advanced practice nursing student experiential learning related to integrating mental and physical health care. We propose to make IHC WOW a delivery model that is distinctive, sustainable, and exceptionally cost-effective, as well as able to be replicated so as to build capacity for unparalleled health outcomes for a broader group than we now serve.