Group Work: Does it Really Help?Group Work: Does it Really Help?

Unified Community Services, Grant and Iowa Unified Community Services, Grant and Iowa Counties, Wisconsin Counties, Wisconsin

Change Team Members: Marjorie Bennett, Change Team Members: Marjorie Bennett, Myranda Culver, Cheryl Knapp and Jeff LockhartMyranda Culver, Cheryl Knapp and Jeff Lockhart

Change Project Dates: May, 2012 to October, 2012Change Project Dates: May, 2012 to October, 2012

Big Aim: to prevent all re-hospitalizations for Community Big Aim: to prevent all re-hospitalizations for Community Support Program (CSP) consumers that had been previously Support Program (CSP) consumers that had been previously hospitalized during 2011 or 2012 hospitalized during 2011 or 2012

-The goal of preventing re-hospitalizations including reducing -The goal of preventing re-hospitalizations including reducing hospitalizations related to both mental health and physical healthhospitalizations related to both mental health and physical health-In 2011 there were -In 2011 there were three three psychiatric hospitalizations for CSP psychiatric hospitalizations for CSP consumersconsumers-In 2011 there were -In 2011 there were three three hospitalizations for medical reasons by hospitalizations for medical reasons by CSP Consumers and CSP Consumers and three consumer deaths related to natural three consumer deaths related to natural causescauses-For the past three years 24-For the past three years 24% % of the CSP Consumers that ended of the CSP Consumers that ended services did so due to physical health conditions services did so due to physical health conditions -So far in 2012 there have been -So far in 2012 there have been seven seven psychiatric psychiatric hospitalizations for CSP consumers, with hospitalizations for CSP consumers, with three three of the of the hospitalizations either being preceded by or followed by hospitalizations either being preceded by or followed by hospitalizations related to physical health conditionshospitalizations related to physical health conditions

Little Aim: to increase coping mechanisms for CSP Little Aim: to increase coping mechanisms for CSP consumers in order to prevent re-hospitalizations through consumers in order to prevent re-hospitalizations through use of a symptom management groupuse of a symptom management group

First change: Staff started a symptom First change: Staff started a symptom management group that included walking as a management group that included walking as a coping mechanism. coping mechanism.

The goal of walking during group time was to try to The goal of walking during group time was to try to decrease symptoms of depression and anxiety and to decrease symptoms of depression and anxiety and to increase positive social interactions. *Monthly increase positive social interactions. *Monthly measurements were to be taken of consumermeasurements were to be taken of consumer’’s anxiety s anxiety and depression, along with weight and waist and depression, along with weight and waist circumference. The symptom management group was circumference. The symptom management group was discussed with all Community Support Program discussed with all Community Support Program Consumers prior to the group beginning. Consumers prior to the group beginning.

Changes made along the way included Changes made along the way included after one monthafter one month adding the group to all Community Support Program adding the group to all Community Support Program Consumers monthly calendars, even if they decided not Consumers monthly calendars, even if they decided not to attend, so they would have the option should they to attend, so they would have the option should they change their minds.change their minds.

After two months staff decided to do the anxiety and After two months staff decided to do the anxiety and depression measurements at every group session instead depression measurements at every group session instead of on a monthly basis. of on a monthly basis.

By three months staff decided to continue to use walking By three months staff decided to continue to use walking as a coping mechanism for consumers, along with other as a coping mechanism for consumers, along with other group activities to include relaxation and mindfulness group activities to include relaxation and mindfulness techniques that are taught during group sessionstechniques that are taught during group sessions

Did re-hospitalizations occur during Did re-hospitalizations occur during the reporting periodthe reporting period ??

Over all of 2011 and most of 2012 Over all of 2011 and most of 2012 there were 11 psychiatric there were 11 psychiatric hospitalizations for consumers and sixhospitalizations for consumers and six hospitalizations related to physical hospitalizations related to physical health symptomshealth symptoms

During the reporting period four of the During the reporting period four of the originally hospitalized consumers originally hospitalized consumers attended the symptom management attended the symptom management group with zero re-hospitalizationsgroup with zero re-hospitalizations

Seven of those hospitalized did not Seven of those hospitalized did not attend the symptom management attend the symptom management groupsgroups

Three of those consumers were re-Three of those consumers were re-hospitalized during the group reporting hospitalized during the group reporting period of May, 2012 to October, 2012 period of May, 2012 to October, 2012 (two for psychiatric stability and one to (two for psychiatric stability and one to stabilize physical health symptoms)stabilize physical health symptoms)

0 5 10 15

Hosp.

Group

Non-Group

Re-hosp.

Adopt, Adapt, Or Abandon Adopt, Adapt, Or Abandon Changes?Changes?

The Symptom Management Group did have a positive correlation to The Symptom Management Group did have a positive correlation to the number of re-hospitalizations for those who attended the groupthe number of re-hospitalizations for those who attended the group

The group will continue with weekly sessions, including measuring The group will continue with weekly sessions, including measuring depression and anxietydepression and anxiety

The group will not focus on walking at every group and will use the The group will not focus on walking at every group and will use the time to teach other symptom management skills time to teach other symptom management skills

The CSP nurse will continue to monitor physical health symptoms to The CSP nurse will continue to monitor physical health symptoms to include waist circumference and weight on a monthly basis include waist circumference and weight on a monthly basis

The group will continue to be offered to all CSP consumers through The group will continue to be offered to all CSP consumers through verbal notification and through adding this to monthly calendars verbal notification and through adding this to monthly calendars given to each consumergiven to each consumer

Everyone Had Positive GainsEveryone Had Positive Gains

Our CSP gained $ from holding the Our CSP gained $ from holding the Symptom Management Group for one week Symptom Management Group for one week versus the potential cost that could have versus the potential cost that could have occurred from one three day hospital stay by occurred from one three day hospital stay by one of those that participated in the group($ )one of those that participated in the group($ )

CSP Consumers that have attended the group CSP Consumers that have attended the group have expressed an interest in continuing the have expressed an interest in continuing the groupgroup

What We Hope to Do in the What We Hope to Do in the FutureFuture

Continue the Symptom Management Continue the Symptom Management GroupGroup

How do we get other consumers to have How do we get other consumers to have better focus on their physical and mental better focus on their physical and mental health symptomshealth symptoms

We know group work is not for everyoneWe know group work is not for everyone