Integrated Health Care (IHC)

Integrated Health Care (IHC)

College of Nursing, University of Illinois at Chicago

Background & Goal

Individuals with serious mental illness (SMI) are at higher risk for serious conditions such as cardiovascular disease, diabetes, and obesity because they are less likely to access health care services. The lack of proper health care for this high risk population results in increased mortality rates and a life span that is 25 years less than the general public. Integrated Healthcare Center’s goal is to dramatically improve health outcomes of people with SMI by transforming fragmented physical and mental health care to an integrated evidenced-based system of care provided by Advanced Practice Registered Nurses (APRNs) in collaboration with community partners.

Center Description

Integrated Health Care (IHC) is a nurse-managed center with the University of Illinois at Chicago (UIC) College of Nursing run by faculty APRNs which provide integrated, ongoing primary and preventive care, education, behavioral and mental health care to individuals with SMI. IHC coordinates care with Thresholds’ (Chicago’s largest interdisciplinary freestanding psychiatric rehabilitation organization) case managers and psychiatrists. Services are provided in four clinics. Recognizing clinic-based services remained inaccessible for homebound Thresholds’ members, IHC received 5 year HRSA funding in 2008 and began ‘IHC Without Walls’ (WOW) for the homebound population. IHC also received one of ten Affordable Care Act awards to nurse managed centers to expand services to underserved populations and increase capacity for Nurse Practitioner education.

For More Information Contact:

Judith Lloyd Storfjell, PhD, RN, FAAN

jissa@aol.com
http://www.uic.edu/nursing

Lucy Marion, PhD, RN, FAAN

Center Founder

Evidence of Success

IHC Clinic-based clients:

  • Lower blood pressure: 67.2% of members with hypertension had blood pressures less than 140/90. Of those with elevated blood pressures in 2011, 83% had normal blood pressures on their most recent visit. 
  • Lower cholesterol: 11.6% decline in total cholesterol and a 13% decrease in low density lipoprotein (LDL) cholesterol. Of the patients with one or more reading over 100, 73% demonstrated a 5 point drop in LDL in 2011, with a number of dramatic drops such as a decrease of 96 points from LDL 161 to LDL 65 and a decrease of 83 points from a LDL 153 to LDL 70. 
  • Lower blood sugar: 22.9% decline in hemoglobin A1c or blood glucose levels; 88% of A1c tests performed on the entire at-risk for diabetes population were below 7; 75% of those with diabetes were below 7. 
  • Weight loss: 73% of clients had a 3% or greater loss in body weight or remained stable. 

IHC WOW clients:

  • Lower blood sugar: 86% of diabetic members had blood sugars with normal range of A1c blood results which meet American Diabetes association standard, and exceeds our target of 75%.
  • Blood pressure: percentage of patients in Group Homes exceeding our blood pressure target of 140/90: Group Home 1=77%; Group Home 2=83%; Group Home 3=86%; Group Home 4=69%.
  • Weight loss: 60% of obese members lost weight and 24% stabilized their weight.
  • Mental health status: 47% of WOW clients had an increase in mental health status scores, and 21% stabilized.
  • Qualitative results: Telemonitoring showed promising results, with two members’ improvement leading to independent living, and another member attributing telemonitoring to his success in smoking cessation.