"Remember, she has life-threatening seizures. Do not let her die." Those were the instructions I was given every morning by the nurse who released a young girl into my care. It was early in my career as a special education teacher, and I had a classroom of eight children with developmental disabilities, all of whom were deaf and blind.

 

Each morning, I had heard the nurse's words. I had attended the required general training for seizures. I had even witnessed the young girl have a seizure. But on the day she had a seizure in my classroom, those reminders, that training and that experience was not enough. As she began turning blue, I yelled for help, but the other classrooms were empty. Frantic, I picked her up and ran as fast as I could to find the nurse. With each step, I hoped and prayed.

 

The nurse helped the girl through the seizure, and once the girl was stable, the nurse turned to me. "Did you not read the medical record? Did you not understand what to do? Do you know that some of the things you did made it worse?" The questions rang in my ears and tore at my heart. I realized how unskilled I was, and that fear propelled me. I began reading all my students' medical information. I started asking medical staff questions. The silos that separated medical and educational staff at the school began to crumble, and I saw first-hand how important collaborative care truly is in attaining the best outcomes.

 

Presently in western North Carolina, an impressive team has come together as the guiding leadership for continuing education focused on collaborative care. Members of the Whole Person Care Curriculum Advisory Council are community members-your colleagues and mentors. There are representatives from Community Care of North Carolina, Federally Qualified Health Centers, universities and healthcare systems. There are family practitioners, psychiatrists, peer support specialists and state representatives. The council's first event, the Transforming Care Conference at MAHEC, offered participants an opportunity to stand at the forefront of a collaborative transformation of health care in our region. Experts offered advice and shared their experiences in delivering truly person-centered, collaborative care while implementing evidence-based treatment to improve outcomes in a cost-effective way.

 

Honoring this turning point in approach is at the heart of Smoky's mission: to successfully evolve in the health care system by embracing innovation, adapting to a changing environment, and maximizing resources for the long term benefit of the people and communities we serve. Recently, Smoky determined the current baseline of collaborative care in our region using two nationally recognized tools: the Integrated Practice Assessment Tool (IPAT) and the Certified Community Behavioral Health Clinic Certification Criteria Readiness Tool (CCBHC CCRT). Once the data is compiled, we will share what we've learned with you, our providers, and discuss a timeline for periodic reassessments.

 

With a shift in approach to care comes a shift in language as well. Smoky's Integrated Care Committee has worked to develop a glossary based on the Integration Lexicon developed by the Agency for Healthcare Research and Quality (AHRQ). You'll find a link to the lexicon in this bulletin, and we encourage you to share it with your staff as a way to begin a conversation about why integration is important. Words matter. 

Smiling to your heart,

Christina