Presented by: J. Raymond DePaulo, M.D. and Anita Everett, M.D.
American Hospital Association
Special Conference Call
How Johns Hopkins Became and Remains a
High-Quality Psychiatric Provider
Anita Everett, MD
Section Chief
Community and General Psychiatry
The Johns Hopkins Bayview Medical Center
Observations of a
Relative Newcomer
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Organizing Elements
 Patients
 Faculty and Staff
 Administrative System
 Community Connection
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PATIENTS
 Primary, secondary, tertiary care
 Institutional commitment to uninsured
and complex patients
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FACULTY and STAFF
 Nursing – respected as professionals
 Medical
National and international experts AND grounded in shared
institutional vision
Attitude of active participation in regulatory necessities
(View compliance as part of supporting the institution)
Salaried (supports value for all patients)
Embrace clinical challenges and complex problem-solving
Respect for decisions administration makes
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ADMINISTRATIVE SYSTEM
 Shared vision and commitment to support
of clinical mission as well as teaching and
education
 Shared vision regarding the place/position
of the institution
 Institution-wide spirit of cooperation in
terms of clinical care, research and
teaching.
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COMMUNITY CONNECTION
 Maintain good working relationships with state
mental health department and other decisionmakers in the services system
 Support of faculty holding organizational
leadership roles that increase JHU visibility
 Hospital generally does a great deal of local
community stewardship
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J. Raymond DePaulo, M.D.
Chairman, Department of Psychiatry and
Behavioral Sciences, The Johns Hopkins
University School of Medicine
Psychiatrist-in-Chief, The Johns Hopkins Hospital
Thoughts from a Career
at Johns Hopkins
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Outline
 Historical Foundations
 Culture of Faculty and Staff
 Policies and Procedures
 Vision of the Future
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Our Founding Mission
The Aims of a Psychiatric Clinic - Adolf Meyer, 1913
“…a psychiatric clinic, therefore, is a hospital for teaching as well as for
treatment and study of mental disorder.”
“I should like to see a clinic give one half
of its beds to intensive work on a limited
district and bestow the other half on intensive
work on special clinical problems…”
With this vision he founded one of the first
psychiatric clinics to be fully integrated
into academic medicine.
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Historical Foundations
 Mission-driven
- Comprehensive care for the community
- Treat the most difficult cases in areas of our expertise
 Trained generations of physician/psychiatrists using an
explicitly pluralistic, multidisciplinary approach to
patients with a variety of problems
 Taught concepts of disease, temperment, behavior, and
narratives (McHugh and Slavney) that built on Adolf
Meyer’s approach to care of the whole person
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Culture of Faculty and Staff
 Clinical work, research, and education are all mutually
supportive activities. All clinically trained faculty do clinical work
in a teaching setting.
 Research mission does not drive educational or clinical work. In
fact, opposite is true.
 Culture of collaboration and integration across disciplines,
divisions, departments and schools.
 Because we treat the most complex patients, we have unique
experience that continually reinforces expertise.
 Commitment to excellence in everyday clinical issues in
community patients
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Policies and Procedures
 The core mission of patient care drives our policy decisions.
 We look for opportunities to subjugate financial and regulatory
burdens to models of care rather than the reverse.
 The organization of our inpatient units helps to produce not only
good care but also models of patient care
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Disease Burden by Illness - DALY
High Income Countries | All Ages | 2004
0
Unipolar depressive disorders
Ischaemic heart disease
Cerebrovascular disease
Alzheimer's and other dementias
Alcohol use disorder
Hearing loss, adult onset
Chronic obstructive pulmonary…
Diabetes mellitus
Trachea, bronchus, lung cancers
Road traffic accidents
% of total DALYs
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4
6
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15.2%
DALY = Disability-Adjusted Life Year (measures healthy life years loss to premature death and disability)
Source: World Health Organization – Burden of Disease Statistics, 2004
Vision for the Future
Our current work and initiatives fall into three major themes:
TRANSLATION | Translational Centers in Major Psychiatric Diseases
To accelerate translation of genetic and molecular discoveries into rational
treatments and accessible models of care for major psychiatric diseases:
mood disorders, memory disorders, anxiety disorders, schizophrenia, and
autism.
PREVENTION | Center for Behavior in Medicine
To draw on our expertise in addictions and eating disorders to create prevention
strategies for some of the most common and costly medical conditions:
obesity, diabetes, heart disease, cancer, HIV.
DRUGS AND BEHAVIOR | Center for Substance Abuse Research
and Treatment
To bring our models of patient care, based on decades of pioneering research on
the treatment of opioid dependence to a broader audience
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Vision for the Future
Mental Illness in the 21st century
 New molecular methods – genomics and epigenetics
– as well as brain imaging, will produce new ways to
interrogate the brain to help explain disease
mechanisms.
 Translating this knowledge will enable surer and
faster diagnosis and lead to treatments that are
rational and more effective.
 Understanding these disorders will change
fundamentally the experience of patients and
families.
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Summary
 Our history provides continuity
and comprehensiveness
in patient care
 Our faculty and staff are
mission-driven
 Our mission and science drive policies
 Research will guide improvements to patient
care
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Thank You
We are happy to answer questions:
J. Raymond DePaulo, M.D.
Anita Everett, M.D.
Beth Ambinder, BSN, MBA
Administrator
Department of Psychiatry and Behavioral Science
www.hopkinsmedicine.org/psychiatry
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