ACLP Applc Don Lipsitt 2024

Nominations for the Lipsitt Award may be made by the candidates themselves or by others on their behalf. Nominations are submitted online using this form. For more information and award criteria, see Don R. Lipsitt Award

Deadline April 30

1. Your contact details *This question is required.

First name
Last name
Credentials (MD, etc.)
Email
Academic/professional title and affiliation

2. Are you nominating yourself or another? *This question is required.

Is your nominee aware that you are nominating them? *This question is required.

Your contact details *This question is required.

First name
Last name
Credentials (MD, etc.)
Email
Academic/professional title and affiliation

3. Please describe the nominee's contribution(s) to the field of Collaborative Care and how this demonstrated strong innovation and advancement of knowledge or practice in Collaborative Care, for example, through expansion of Collaborative Care to new treatment settings, diagnoses, and/or populations. Please consider the ACLP/APA definition of Collaborative Care (below) when responding. (There is a 200 word limit to your response)

Collaborative care is the provision of care that is team-driven, population-focused, measurement-guided, and evidence-based. A Collaborative Care team is multidisciplinary, shares roles and tasks, and together is responsible for the health outcomes of their patients. As a whole, the team is focused on the entirety of their patient population, regardless of the patient's current level of engagement in treatment. Together, this team utilizes measurement-guided patient-centered outcomes to guide the delivery of evidence-based care in order to achieve “treat-to-target” clinical goals for each patient. *This question is required.

4. Describe the scope of the nominee's work in the field of Collaborative and Integrated Care through research/scholarship (e.g., federal research funding, publications), clinical systems development (e.g., creation of hospital-wide, regional, or national programs; QI projects) and/or education (e.g., development or delivery of novel curricula or programs for psychiatry trainees or interdisciplinary team members). (There is a 200 word limit to your response) *This question is required.

5. Explain how the nominee has demonstrated leadership in Collaborative and Integrated Care research/scholarship, clinical systems development, and/or education. (There is a 200 word limit to your response)

6. Optional: Describe any additional clinical or healthcare policy contributions to Collaborative Care (There is a 100 word limit to your response)

7. In-person attendance and the delivery of a workshop presentation at the annual meeting are required of award winners. Nominations are only accepted if the nominee can confirm both availability to attend the meeting in person AND present a workshop. If selected, will the nominee attend this year's annual meeting in person and deliver a workshop? *This question is required.

8. Please upload the nominee's CV (MS-Word or PDF file formats only; max file size 1MB; please include the nominee name in the filename) *This question is required.

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9. Please upload nominee's portrait photo. Photos are not used in judging and only the photo of the award winner is used for annual meeting program presentation purposes. Accepted file formats: png, gif, jpg, jpeg; max file size 1MB *This question is required.

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10. Please provide a 150-word bio for the nominee in a format that could be referenced in advertising or read aloud when introducing the nominee as an award winner at the annual meeting. This information will not be used in the judging process. *This question is required.

11. Please provide the phonetic spelling of the nominee's name

There are no further questions. Click Submit to file this application. Thank you.