Medical Music Therapy.docx

Biopsychosocial (Sarafino, 1998) bio | genetic, physiological | neuro / medical model informed psycho | behaviors, cognitions, motivation, emotion | CBT with humanistic influences social | family, community, cultural, values regarding healthcare delivery and outcomes There is no one protocol for t...

Biopsychosocial (Sarafino, 1998) bio | genetic, physiological | neuro / medical model informed psycho | behaviors, cognitions, motivation, emotion | CBT with humanistic influences social | family, community, cultural, values regarding healthcare delivery and outcomes There is no one protocol for the therapeutic process. There are approaches, methods, models, techniques, ongoing and evolving information gathering, and the resulting clinical decision-making involving music + therapeutic strategies. Units & Services Oncology | Pediatrics | Cardiovascular | Pulmonary | Orthopedics | Labor & Delivery | Neonatal Care | Neurology | Emergency | Hospice & Palliative Care | Transplant | Intensive care - 1) Heart rate 2) Oxygen saturation 3) Respiratory rate 4) Blood pressure Dynamic environmental Safety = infection Interprofessional Time-limited Terminology What are common referral areas and thus goals in adult medical psychosocial music therapy care? (Gooding ch 9) Pain Anxiety/agitation Stimulation Mood/Depression Coping Communication Motor Reality Orientation Respiratory Support Physiological Stability Family Support What are common TMEs used in medical psychosocial music therapy care? (Gooding ch 9) Active Music Making Song Writing PPLM Distraction Lyric Analysis Music Assisted Relaxation Iso-Principle Contingent Music Singing Counseling Techniques Referral (See Module Resources) Palomar Rehab Referral Sheet UKHC Referral Guidelines You receive a referral through the hospital's Electronic Medical Record (EMR) system (Cerner) for you male approximately 38 years old. He was minimally conscious following head trauma (motor vehicle accident (MVA), stroke, or aneurysm). His "face sheet," and the referring team indicated that his family is of Middle Eastern descent with his mother present at the bedside. The referral was from the Palliative Care Team for comfort care. How would you proceed? Reimbursement - Starts with referral 3 Must-knows and do's for Reimbursement 1. Who can give a referral A physician Possibly: Advanced Practice Registered Nurse (APRN) Physician Assistant (PA) Nurse Practitioner (NP) - check laws and guidelines. 2. How you can use the Current Procedural Terminology (CPT) codes Which ones can you use, how many units, and when Inpatient medical care is often bundled by diagnosis - not codes - MT is not reimbursed - cost is negotiated with insurance contracts Outpatient care is more code specific and you have to consider what other disciplines might be using the same codes - duplication - illegal 3. Document services Set up the EMR to capture what you want for documentation, program evaluation, and if desired, hypothetical reimbursement. Work with the billing department to establish back-end capturing of services. Other funding options? Direct unit funding Foundations - donors, endowments through the hospital or other (e.g. Ryan Secrest, Music Rx) Grants Research Revenue retention - demonstration of cost savings (pain medication, length of stay, readmission, pt satisfaction) Session Flow Sheet PDF Documentation UKHC MT Progress Note - See Module Resources - Kevin Parr Note Example Medical notes are objective and concise Subjective - in medical this is usually factual about the subject, not subjective information MT-BC and MT student present, pt presented laying in bed, verbally agreed to music therapy Objective - what is the objective Pt seen to decrease pain and anxiety Assessment - what happened (including MT interventions), patient responses, other key information - what is valuable for the team to read? above narrative Plan - recommendations and plan for treatment MT will attempt to follow up twice per week to address above goals Set up Program Assessment / Evaluation Measures What is the EMR? Electronic Medical Record Examples: Cerner; Epic What does MVA stand for in medical terminology? Motor vehicle accident What is an aneurysm? A bulge in a blood vessel (artery - away from the heart) from a weakened wall. There are limited symptoms and it can be treated if detected prior to rupturing. When it ruptures (hemorrhagic stroke) that means blood flow beyond the site is compromised or non-existent. https://www.nhs.uk/conditions/brain-aneurysm/ Describe Palliative Care "Palliative care is meant to enhance a person's current care by focusing on the quality of life for them and their family. A palliative care team is made up of multiple different professionals that work with the patient, family, and the patient's other doctors to provide medical, social, emotional, and practical support." NIA What is Comfort Care? Care that focuses on quality of life & symptom control. What are CPT codes? The define specific services and units of time spent providing the service. What are 3 required pieces involved in reimbursement? Qualified referrer providers Accurate and appropriate use of CPT codes Documentation of services Note that if working in outpatient there is paperwork and documentation required at multiple timepoints marking all steps of the treatment process (e.g. assessment, pre-approval, evaluation). Music Therapy Ed & AMTA have courses that walk you through these processes. What are two elements of MEDICAL documentation that are important to keep in mind? Objectivity & Consciousness