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Article   |    
Reorganization of a Private Psychiatric Unit to Promote Collaboration With Managed Care
Neil J. Baker; Alexis A. Giese
Psychiatric Services 1992; doi:
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The authors thank Steve Dubovsky, M. D., for the original idea for the program; Bob Tank, Jr., M. S. W., for suggestions and support; and Heidi Van Fleet, R. N., Jo Van Dyck, M. S. W., Judy Linn, R. N., Bonnie Young, R. N., Sue Orahood, R. N., and Jeannie Cooper, R. N., for their strenuous work in developing the program.

Group Health Cooperative of Puget, Sound, 1730 Minor Avenue, Suite 1400, Seattle, Washington 98101

University of Colorado Health Sciences Center in Denver

1992 by the American Psychiatric Association

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Managed care organizations have become significantly involved in health care in the Denver metropolitan area. Their presence has challenged psychiatric hospitals to reduce costs and length of stay. In 1990, a locked private psychiatric unit was reorganized into locked, open, and partial care services through which patients progress at individualized rates. One treatment team manages patients in all settings, allowing a reduction in staffing costs and flexibility in treatment design. The hospital administration takes an active role in facilitating collaborative decision making between hospital clinicians and managed care representatives. In the first year after reorganization, length of stay was significantly reduced; 90 percent of patients were discharged from 24-hour care within ten days or less, whereas only 40 percent were discharged within that time in the original program. Staffing costs were reduced by 15 percent. No increase in recidivism was noted.

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