The eating disorders (e.g., Anorexia Nervosa, Bulimia Nervosa) are serious illnesses that are difficult to treat and require a coordinated, multifaceted patient- and family-centered approach. Challenges inherent in working with this group include high rates of treatment refusal, dropout, and relapse, and inefficient use of treatment resources, contributing to high levels of hospital dependency and revolving door admissions. The BC Clinical Practice Guidelines for Eating Disorders are based upon current research evidence, clinical expertise and patient and family involvement.

Three features of the guidelines provide cutting edge, innovative means to address these challenges.

1) The Short Treatment Allocation Tool for Eating Disorders (STATED) is an evidence-based algorithm recommending that treatment be tailored to three key characteristics: Medical stability (immediate medical risk), Symptom severity/Life interference (level of disruption as a result of the eating disorder), and Readiness/Engagement (readiness for recovery-focused treatment). See Fig 1 in the Appendix.

2) The provision of a menu of treatment options.

3) Clear expectations of patients in order to ensure their safety and autonomy. Clear expectations of staff to ensure they use a consistent approach with all patients, maximizing collaboration and trust, thus enhancing clinical outcomes and treatment resource utilization. We refer to these as “treatment non-negotiables.” The leading practice described in this submission is the implementation of the BC Clinical Practice Guidelines at the Provincial Adult Tertiary and Specialized Eating Disorders program (PATSED): Offering the right treatment to the right patient at the right time. PATSED is the first center in Canada to implement these guidelines into practice.

The impact includes:

1) Implementation of a referral form that uses STATED criteria

2) Provision of a phased inpatient program, preparatory outpatient treatment and hospital day program where patients are matched to programs using STATED criteria.

3) Reduced patient distress and increased readiness due to clear expectations and consistency.

Email: Dr. Geller jgeller@providencehealth.bc.ca; Dr. Raudzus jraudzus@providencehealth.bc.ca; Patty Yoon pyoon@providencehealth.bc.ca

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