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About CHAMMP
What is CHAMMP?
The Center for Healthcare Improvement for Addictions, Mental Illness and Medically Vulnerable Populations (CHAMMP) was recently established at Harborview Medical Center (HMC). HMC’s Board of Trustees designated CHAMMP as a Center of Emphasis in recognition of the pressing need to focus research and training on some of the most intractable problems facing medicine and society--the co-occurring conditions of addictions, mental illness, and/or medical vulnerabilities. The primary mission of CHAMMP is to improve the quality and coordination of care for disadvantaged patients with these co-occurring conditions.
CHAMMP is directed by Peter Roy-Byrne, MD. Dr. Roy-Byrne is Chief of Psychiatry at HMC and professor and Vice-Chair of the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine. The Associate Director is Toni Krupski, PhD. She is Research Associate Professor within the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine. Prior to joining CHAMMP, Dr. Krupski worked for over a decade with the State Division of Alcohol and Substance Abuse coordinating their efforts to use research to impact policy in this area.
Origins of the Center
There is no overarching system to track mentally ill, chemically dependent and medically vulnerable patients, many of whom have problems in all three areas. These patients migrate back and forth between multiple, disconnected systems of care including psychiatric inpatient units, emergency rooms, community health clinics, jails, the state psychiatric hospital, other medical hospitals and substance abuse centers.
To compound this situation, Washington State has very limited funds for psychiatric problems, with only the most severely mentally ill, typically those with schizophrenia, bipolar illness, severe depressions, and chronic risk of suicide, qualifying for care. People with mood and anxiety disorders, who suffer less than total and chronic disability, are left out of the system despite suffering significant impairment. Many also have substance use problems and medical illness. These people are most often seen in safety net medical settings such as HMC which are being increasingly challenged to respond to their complex needs.
Harborview’s board of trustees recognized that a coordinated system of care and innovative approaches to treatment were needed for these patients who not only fall through the cracks but also put an avoidable burden on both county and state resources. However, there is currently little understanding or data about the prevalence, risk predictors, and most effective treatment approaches for these problems that could guide the development of new policies and programs. CHAMMP's purpose is to fill this void.
Why Harborview Medical Center (HMC)?
HMC is a county hospital serving the indigent and uninsured that has been managed by the UW School of Medicine for over 60 years. Since the late 1960’s, HMC has been recognized as a full-fledged, modern academic medical center, leading to clinical advances and innovations as well as major teaching and research achievements. A significant proportion of HMC’s medically ill patients have co-morbid disorders involving addictions and mental illness which makes it a particularly suitable site for the study of these co-occurring disorders. Clinicians from a variety of disciplines including medicine, surgery, psychology, pediatrics, social work, and nursing, work together to care for these patients.
HMC’s strong research tradition delivered in the context of expert clinical care and training provides an important background for the CHAMMP center. Investigators who are conducting research are also delivering care in this same setting and are often providing clinical program administration as well. Thus, the center is staffed by a group of investigators who bring a rich experiential knowledge base and perspective that is not usually found in a research center. Most typically, CHAMMP investigators follow the Physician-Scientist model again, making them unusually suited to design and conduct research focused on health care improvement.
Learn more about Harborview Medical Center
CHAMMP’s Goals
CHAMMP is organized around three integrated goals:
- Funded research collaborations that design and test innovative programs of evaluation and treatment
- Partnerships with community stakeholdersthat develop new projects and disseminate findings from previous projects through expert training
- Expansion of data linkages and treatment coordination throughout the state using a pilot database integrating information from multiple services at HMC as a template
Funded research collaborations
One of CHAMMP’s primary goals is to develop collaborative, funded research studies that look at new models of treatment and care. The idea is to help close current gaps in caring for patients by designing and testing new evaluation and treatment programs by securing funding for studies involving a variety of multidisciplinary specialties. There are many exciting funded research studies already in motion at CHAMMP. Click here to view current projects.
A second way CHAMMP is implementing this goal is through the Small Grants Program. The purpose of this program is to facilitate research collaborations between psychiatry and other medical specialties including other allied health professionals (such as nursing and social work) on research projects that are related to the center’s goals. At this time, only investigators working at the HMC are eligible for these awards. It is expected that projects funded through the Small Grants Program will be used to leverage/provide data for larger externally funded grant applications. Three small grants were awarded in 2006 to investigators outside the Department of Psychiatry. New small grants will be awarded in the late spring of 2007. Click here for more information on CHAMMP’s Small Grants Program.
Finally, twice a month interested investigators are invited to attend CHAMMP research presentations. This meeting is open to researchers who have an interest in the work being conducted in CHAMMP. Current attendees have included not only HMC researchers but individuals from the School of Social Work, Nursing, Department of Medicine, and the Veterans Administration.
Partnerships with community stakeholders
A second CHAMMP goal focuses on partnering with the state and county to both disseminate findings to the community of healthcare providers and to partner with community stakeholders to develop new projects. CHAMMP has a unique opportunity to strengthen ties with the state through existing formal links with the State Division of Mental Health (MHD), the State Division of Alcohol and Substance Abuse (DASA), the Mental Health Transformation Grant, and the state-funded Washington Institute for Mental Illness Research and Training (WIMIRT). For example, CHAMMP faculty Rick Ries, MD, serves as Medical Director to both DASA and the MHD. CHAMMP faculty Kate Comtois, PhD, serves in a leadership role within WIMIRT. There is also good opportunity to nurture a growing partnership between CHAMMP and King County where CHAMMP faculty Debra Srebnik, PhD holds a position as Program Evaluator within the Department of Community and Human Services, Mental Health, Chemical Abuse and Dependency Services Division.
Visit the State Division of Mental Health web site
More information on the State Division of Alcohol and Substance Abuse
More information about the Washington Institute for Mental Illness Research and Training - Eastern Branch
More information about the Washington Institute for Mental Illness Research and Training- Western Branch
Visit the Mental Health Transformation Grant web site
More information about the King County Department of Community and Human Services, Mental Health, Chemical Abuse and Dependency Services Division
Expansion of data linkages and treatment coordination
The third goal is focused on ensuring that data are collected at HMC across multiple services in a format that allows questions to be answered about the kinds of problems patients have, the kind of care they receive, the specific services being offered, the actions that still need to be taken, any gaps in treatment or care, and the level of treatment success. A Methods Core has been established which is staffed by a director and two research analysts. As part of the Methods Core, a weekly seminar focused on methodological issues is offered to all interested investigators. An initial pilot project to identify prevalence and types of mental health/addiction problems among HMC patients is already underway.
A contract from the Washington State Department of Social and Health Services (DSHS) to the University of Washington--CHAMMP to assess outcomes of patients screened at HMC in the Washington State Screening, Brief Intervention, Referral and Treatment Program (WASBIRT) was finalized in November 2006. The contract represents a collaboration between CHAMMP and the Washington State DSHS/DASA, the organization that was funded to develop and implement the WASBIRT project statewide. Data sharing is an important component of this project. It is expected that the procedures developed in this project will serve as a prototype for future data sharing efforts.
Faculty
CHAMMP FACULTY
(Based at Harborview Medical Center)
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Director | |
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| Peter Roy-Byrne, MD | Psychiatry and Behavioral Sciences | ||
| Associate Director | |||
| Toni Krupski, PhD | Psychiatry and Behavioral Sciences | ||
| Methods Core Director | |||
| Jutta Joesch, PhD | Psychiatry and Behavioral Sciences | ||
| Faculty (Based out of Harborview Medical Center) | |||
| David Avery, MD | Psychiatry and Behavioral Sciences | ||
| Lucy Berliner, LICSW | School of Social Work, Center for Sexual Assault & Traumatic Stress | ||
| Dedra Buchwald, MD | Medicine, General Internal Medicine | ||
| Paul Ciechanowski, MD, MPH | Psychiatry and Behavioral Sciences | ||
| Naomi S. Chaytor, PhD | Neurology, Regional Epilepsy Center | ||
| Lisa Chew, MD, MPH | Medicine, General Internal Medicine | ||
| Kate Comtois, PhD | Psychiatry and Behavioral Sciences | ||
| Heidi Crane, MD, MPH | Medicine, Allergy and Infectious Diseases | ||
| Christopher Dunn, PhD | Psychiatry and Behavioral Sciences | ||
| Jordan Firestone, MD, PhD, MPH | Medicine, General Internal Medicine, Occupational And Environmental Medicine and Neurology | ||
| Cynthia Gries, MD | Medicine, Pulmonary and Critical Care | ||
| Robert Harrington, MD | Medicine, Allergy and Infectious Diseases | ||
| Stephen C. Hunt, MD, MPH | Medicine, General Internal Medicine, Occupational And Environmental Medicine | ||
| Daniel Lessler, MD, MHA | Medicine, General Internal Medicine | ||
| Sherry Lipsky, PhD, MPH | Psychiatry and Behavioral Sciences | ||
| James LoGerfo, MD, MPH | Medicine, General Internal Medicine | ||
| Barbara McCann, PhD | Psychiatry and Behavioral Sciences | ||
| Michael McDonell, PhD | Psychiatry and Behavioral Sciences | ||
| Joseph Merrill, MD, MPH | Medicine, General Internal Medicine | ||
| John Miller, MD, PhD | Neurology, Regional Epilepsy Center | ||
| Jagoda Pasic, MD | Psychiatry and Behavioral Sciences | ||
| Elizabeth Phelan, MD, MS | Medicine, Gerontology and Geriatric Medicine | ||
| Richard Ries, MD | Psychiatry and Behavioral Sciences | ||
| John Scott, MD | Medicine, Allergy and Infectious Diseases | ||
| Jeanne Sears, PhD | Psychiatry and Behavioral Sciences | ||
| Mark Snowden, MD, MPH | Psychiatry and Behavioral Sciences | ||
| Debra Srebnik, PhD | Psychiatry and Behavioral Sciences | ||
| Eric Strachan, PhD | Psychiatry and Behavioral Sciences | ||
| Alexander Thompson, MD, MBA | Psychiatry and Behavioral Sciences | ||
| Karina Uldall, MD, MPH | Psychiatry and Behavioral Sciences | ||
| Doug Zatzick, MD | Psychiatry and Behavioral Sciences | ||
CHAMMP COLLABORATORS (Based outside of Harborview Medical Center)
| Meg Cristofalo, MSW, MPA | School of Social Work | ||
| Dennis Donovan, PhD | Psychiatry and Behavioral Sciences | ||
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Sharon Estee, PhD | Washington State Department of Social and Health Services, Research and Data Analysis Division | |
| Maria Monroe-DeVita, PhD | Psychiatry and Behavioral Sciences and Washington Institute for Mental Illness Research and Training (Western Branch) | ||
| John Roll, PhD | Washington Institute for Mental Illness Research & Training (Eastern Branch), Washington State University | ||
| Eric Trupin, PhD | Psychiatry and Behavioral Sciences and Washington Institute for Mental Illness Research and Training (Western Branch) |
Click here for more information about CHAMMP faculty
For more information about CHAMMP
For further information about CHAMMP, contact:
Toni Krupski, Ph.D.
Associate Director, Center for Healthcare Improvement for Addictions, Mental Illness and Medically Vulnerable Populations (CHAMMP)
Research Associate Professor
Department of Psychiatry and Behavioral Sciences
University of Washington at
Harborview Medical Center, Box 359911
325 9th Avenue
Seattle, Washington 98104-2499
Phone: (206) 341-4215
Fax: (206) 731-3236
e-mail: krupski@u.washington.edu
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