Past Initiative Tools

The PSYCKES team developed an array of project tools for the medication-focused CQI Initiative. They were designed for clinic Quality Improvement (QI) Teams and for clinical staff to educate staff and consumers, track and manage data, and report progress on the CQI Initiative.

Quality concerns associated with each of the PSYCKES medication-focused projects are detailed in the PSYCKES reference guides:

• Reducing Psychotropic Polypharmacy
• Reducing the Use of Antipsychotics with High or Moderate Risk of Metabolic Side Effects in Individuals with Cardiometabolic Risk Factors
• Reducing the Use of Higher than Recommended Doses of Psychotropic Medications
• Reducing Psychotropic Prescribing Risk for Youth

Scientific summaries are synopses of peer-reviewed scientific literature relevant to the quality concerns of the medication-focused PSYCKES projects.

The 2011 CQI Project Handbook covers the mechanics of implementing the medication-focused PSYCKES CQI project within a FOCUS-Plan-Do-Check-Act quality improvement model. It also covers strategies for engaging leadership, prescribers and consumers.

The Medication-Focused CQI Model was designed to provide practical steps associated with positive project outcomes and to facilitate assessment of CQI processes. The steps are broken down into manageable cycles in the FOCUS-Plan-Do-Check-Act quality model. These include identifying individuals who met the criteria for the selected project, conducting clinical reviews to determine whether a medication change was appropriate, tracking outcomes, and aggregating and reporting data.

Identifying individuals who meet criteria for a PSYCKES indicator set is a crucial step in the CQI process. Positive cases can be identified by using the PSYCKES application or through other means such as screening at intake, quarterly treatment reviews, and chart reviews. A chart review is an effective way to identify cases (both non-Medicaid clients and Medicaid clients). The ‘PSYCKES: Improving the Quality of Psychotropic Prescribing Practices Chart Review Form’ was used to help determine if an individual met criteria for a specific PSYCKES indicator set. There is a chart review form for each of the following four PSYCKES project indicator sets:

• Psychotropic Polypharmacy  (Word)
• Cardiometabolic Risk  (Word)
• High Dose Prescribing  (Word)
• Psychotropic Prescribing for Youth  (Word)

The PSYCKES Clinical Note  (Word) was designed for prescribers to record clinical review outcomes of clients who had been flagged with a quality concern; the QI team used the clinical note data to record status updates on clients. It is a one-page document in a check-box format used to communicate the prescriber's plan to change medication, the justification for not making a change, and the strategy to address barriers to change.

The PSYCKES team has developed resources to educate consumers and their families. PSYCKES brochures explain the quality concerns for the medication-focused projects indicators in user-friendly language.Brochures are available on the following topics:

• Cardiometabolic Risk: What is it and what can I do about it?
• Psychotropic Polypharmacy: What is it and what can I do about it?
• Medication Doses and You - Teaming Up for Better Medication Treatments
• Mental Health Medications and Your Child: What You Need to Know