Case Studies

Norwegian American Hospital - Intensive Outpatient Program

Chicago, IL

Overview
Norwegian American Hospital’s (NAH’s) Intensive Outpatient Program (IOP) provides intensive group therapy to clients with active symptoms of mental illness. IOP began in 2012 to address high hospitalization rates for behavioral health issues and mood disorders in the local community. It serves those with diagnosed mental health issues such as schizophrenia or bipolar disorder who need frequent, intensive therapy, but not as intensive as to require inpatient care. IOP operates five days per week from 10 a.m. to 2 p.m., with each client coming three times weekly for three to six months, participating in group psychotherapy and psychoeducation services that are provided by case managers who are licensed counselors. Each patient follows an individualized treatment plan. The goal is to prevent crises that result in hospital admissions, and to reintegrate clients back into the community.

Currently, 73 percent of IOP clients reside in nursing homes; the remainder live in group homes or the community, often with family who need support to prevent admissions of their loved one to a nursing home. Some of the greatest program successes are clients who are able to move into other living situations, and even go back to school or get jobs. IOP provides coordinated and culturally competent care, including bilingual services to support these client goals. IOP works closely with referral sources, including nursing homes, NAH, and providers such as Dr. Shephali Patel, medical director of IOP, who refers appropriate clients from NAH’s outpatient clinic. Partnering with referring facilities, other providers and families creates a holistic and collaborative approach to care that recognizes that IOP is only part of clients’ lives.

Impact
Since opening, IOP has registered 435 clients, approximately 109 annually. Of those, 38 percent have graduated, meaning they completed the program within 6 months and met all treatment goals. In addition, in 2015, 17 percent of the 128 clients were able to move back into the community via a housing program upon graduation. According to referral sources surveyed at 30-day follow-up, all 2015 graduated clients had avoided re-hospitalization in the 30 days following discharge from IOP, and all were reportedly more stable in their living environment.

Lessons Learned

IOP has taken great strides toward improving individualized treatment plans by creating more measurable outcomes and clearer time frames for treatment goals. This effort was driven by the Medicaid managed care environment, which requires more justification of medical necessity, and by the Joint Commission, which first surveyed the IOP program in 2014. As a result, the program is now fully accredited. It was also learned that few community supports exist for clients when they leave IOP. Staff have identified programs with lower levels of care and refer patients there, including Newman Family Services and Pilsen Wellness Center. Staff also focus on teaching clients life skills, given the lack of other supports.

Future Goals
IOP hopes to expand its physical space and service hours to increase client access. A long waiting list exists, as only 30 to 40 patients can be on the roster at a time and only 18 are seen per day. Additionally, the program only serves adults with chronic illness who need a high intensity of care. Evening hours and adding psychosocial rehabilitation services would enable higher-functioning community members who need a lower intensity of care to benefit from the program.

Contact: Nancy Clarke
Manager, Marketing & Public Relations
Telephone: 773-292-7354
Email: nclarke@nahospital.org


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