To improve communication, a weekly teleconference was implemented via a Web conferencing system in February 2010. Every Thursday at 12:30 p.m., the inpatient and outpatient teams meet to discuss clinical concerns related to Strong Ties inpatients. At the hospital, inpatient team attendees include the attending psychiatrist, psychiatry residents, medical students, nurse practitioners, and social workers. Clinicians present at the Strong Ties location include psychiatrists, nurse practitioners, therapists, and case managers. This meeting usually lasts about 30 minutes, but the duration varies depending on the number of patients and the complexity of their cases. Initially it was peculiar speaking to a video monitor instead of face to face, but the monitor quickly seemed to disappear and we became one large team of clinicians working collectively to provide effective care for our most acute patients.