Use of a Model Maturity Matrix to Build a Quality Improvement Infrastructure for Psychiatric Care

Despite a call to action by accreditation bodies and payers alike, the infrastructure needed to continuously improve the quality and safety of behavioral health care has been slow to develop. The causes of this are complex and multifactorial yet likely include underdeveloped leadership and capacity to sustainably improve the quality of psychiatric care. This article proposes the use of a quality improvement maturity matrix to serve as both an implementation strategy and a self-assessment measure to strategically guide this infrastructure development. The matrix describes six phases of development across three domains that are generalizable to various behavioral health care settings.

Weakness after gastric bypass

Two patients underwent gastric bypasses and had uneventful hospital courses. In the early postoperative periods, both developed severe, protracted vomiting, weakness, and hyporeflexia. After thorough laboratory and clinical evaluations by neurologists, the patients were diagnosed with Guillain-Barré syndrome, although there were many atypical features. The clinical presentations of these patients are very similar to case reports of nutritional polyneuropathy associated with gastric partitioning. This paper addresses the difficulties of differentiating these two diagnoses.