Split treatment: a measurement of coordination between psychiatrists

The objective of this study was to examine the adherence rates of psychiatrists with APA standards for coordination of care in split treatment. Coordination of care in split treatment is monitored from claims paid data in an academic MBHO as an ongoing quality improvement activity. For an 18-month period, 93 psychiatrists were identified with 559 patients in split treatment and were mailed a survey. Surveys were controlled for change of providers. Self-report survey results were obtained from 69 psychiatrists for 295 patients in split treatment. The average rate of coordination was 66 percent; however, the distribution was bimodal with 36 percent of psychiatrists always coordinating and 26 percent never coordinating. Not obtaining a release accounted for 87 percent of non-coordination. In conclusion, while coordination of care in split treatment is an APA standard of practice, only 36 percent of psychiatrists fully complied. That one third of patients in split treatment did not receive coordinated care suggests a need for improvement to meet the APA standards of practice and avoid legal exposure.