Create a Clinical Workflow
It's important to know how your team will function the moment a patient walks through the door, including protocols for suicidal patients and patients in crisis. Planning and creating a clinical flow that shows the exact process of what happens when a patient comes to the clinic ensures that no patient falls through the cracks. Mapping a patient's care experience -- from identifying a behavioral health care need to initiating treatment to communicating treatment adjustments -- gives a framework for knowing the next step of care.
1. The Planning Team, led by the Implementation Leader, should systematically review the results from the Build Your Team section in order to plan for implementation changes and to document these plans. Discussion should center on gaps, duplication, needed training, and/or re-assignments in the context of the “practical ideal” you are striving for to provide the most effective care for your patients.
2. Next, the Planning Team should fill out a Clinical Workflow Plan. For each task—or set of tasks as shown in the worksheet—document who, how, when, and where the task will be completed as part of your implementation plan. This worksheet documents your current situation plus your plans for change and will help you:
- Document how each Collaborative Care task will be changed/accomplished, including plans for smooth hand-offs and communication methods.
- Document when a task is completed, in terms of patient flow (e.g., intake, initial assessment).
- Document where the task will be completed. At the clinic? At a partner agency? Through an external referral?
- Assess whether organizational-level changes ar necessary. Staff training needs? Staff hires? Other needs? Additional supervision?
3. Using the completed Clinical Workflow Plan, the Planning Team should now create a clinical flowchart showing the exact process of what happens when a patient comes to the clinic. Include a protocol for psychiatric emergencies (e.g., suicidal), and pay particular attention to communication among team members (e.g., ensuring recommendations from psychiatric consultant are communicated to primary care provider, providing tools to the primary care provider to ensure patients are referred to the correct team members). Every clinic's flowchart will be unique and there is no right way or wrong way to ensure Collaborative Care tasks get done.