Deconstructing Proactive C-L Psychiatry: Exploring the Elements of Change

Abstract: In line with the conference theme, “Making Connections,” the proactive C-L psychiatry SIG has developed this session to explore how clinical integration transforms care. Medical and psychiatric conditions are closely connected, and the proactive C-L model asserts that only by integrating medical and psychiatric care can we meet our patients’ needs most effectively. Such care integration is also essential to addressing the needs of our colleagues outside psychiatry and broader healthcare systems.



Recognizing that not all sites interested in implementing proactive C-L have the resources, personnel or institutional buy-in needed to launch the full proactive C-L model, we will approach proactive C-L implementation in a modular fashion. This session will be especially relevant for the attendee who says, “I’d like to have a proactive service, but I can’t see how I’d get all the pieces in place. What are my options?” or “I’m already doing some of this. How do I demonstrate the value of enhanced care to develop my service further?”



Worksheet* completion: Each attendee will complete a worksheet that details their practice setting in preparation for the small-group portion (e.g., population demographics, EMR, consult service composition, service volume, common clinical scenarios, unmet clinical needs, degree of administrative buy-in, degree of mental health awareness among unit staff). The worksheet will also include a list of focus questions from each presentation that will be given.

Presentations: Each 20-min presentation will focus on one element of proactive C-L to explore how it transforms care delivery and outcomes. Dr. Oldham will describe his team’s transition from manual to automated EMR-based screening and how this change facilitates workflow. Dr. Kugler will review how the learning environment of proactive C-L fosters inter-professional education. Dr. Finn will present on different mental health team compositions, team member roles, and how a team-based approach allows each clinician to play to their strengths. Dr. Emery will review the how real-time communication and care coordination with inpatient primary teams transforms care delivery. Dr. Bronson will discuss the importance of linking specific elements of proactive C-L with corresponding outcome metrics.



Small-groups: Attendees will break up into small groups for facilitated round-table discussions, using their completed worksheets as a guide. Each participant will have a chance to present on their clinical setting, review potential areas for a needs assessment to inform implementation efforts, and consider potential next steps. Pending the number of attendees, participants may be given the opportunity to rotate groups at regular intervals if they wish.



*Prior to this session, @MarkOldhamMD will post a Twitter thread (#CLP2022proactiveprecon) for registrants to submit questions in advance. The thread will also include links to relevant proactive C-L SIG webpage resources, including the preconference worksheets so registrants can begin completing them in advance.

Agenda Overview: Introduction (< 5 min)

Worksheet completion (10 min)

• Distribute worksheets and give time to complete.

Didactics (1hr 50 min) = (20 min allotted for each of 5 presenters) + (10 min break after 2nd presentation)

• Each presentations: 15 min of prepared remarks and 5 min for audience engagement.


• Given the anticipated size of attendance, we plan to take questions in real-time, though any detailed comments will be deferred to small-group breakout sessions.


• Any remaining time at the end of prepared remarks will be devoted to Q&A and allow attendees to revisit their worksheet responses.

Break (10 min)

Introduction to small-group portion (< 5 min)

Small-group breakouts (1hr 40 min, attendee breaks as needed)

• Attendees will split up into facilitated small groups where they will take turns presenting from worksheets.


• The small groups will serve as a problem-solving forum where attendees obtain practical advice on what elements of proactive C-L might be feasible in their setting and how to identify and measure related outcomes.