Strategic Implementation Planning for Integrated Behavioral Health Services in Pediatric Primary Care.

Autor:	Mautone JA; Department of Child & Adolescent Psychiatry & Behavioral Sciences, Children's Hospital of Philadelphia.; Department of Psychiatry, Perelman School of Medicine at University of Pennsylvania., Wolk CB; Department of Psychiatry, Perelman School of Medicine at University of Pennsylvania.; Leonard Davis Institute for Health Economics at University of Pennsylvania., Cidav Z; Department of Psychiatry, Perelman School of Medicine at University of Pennsylvania., Davis MF; Department of Psychiatry, Perelman School of Medicine at University of Pennsylvania.; Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI)., Young JF; Department of Child & Adolescent Psychiatry & Behavioral Sciences, Children's Hospital of Philadelphia.; Department of Psychiatry, Perelman School of Medicine at University of Pennsylvania.
Jazyk:	angličtina
Zdroj:	Implementation research and practice [Implement Res Pract] 2021 Jan 01; Vol. 2. Date of Electronic Publication: 2021 Feb 01.
DOI:	10.1177/2633489520987558
Abstrakt:	Background: Delivering physical and behavioral health services in a single setting is associated with improved quality of care and reduced health care costs. Few health systems implementing integrated care develop conceptual models and targeted measurement strategies a priori with an eye toward adoption, implementation, sustainment, and evaluation. This is a broad challenge in the field, which can make it difficult to disentangle why implementation is or is not successful. Method: This paper discusses strategic implementation and evaluation planning for a pediatric integrated care program in a large health system. Our team developed a logic model, which defines resources and community characteristics, program components, evaluation activities, short-term activities, and intermediate and anticipated long-term patient-, clinician-, and practice-related outcomes. The model was designed based on research and stakeholder input to support strategic implementation and evaluation of the program. For each aspect of the logic model, a measurement battery was selected. Initial implementation data and intermediate outcomes from a pilot in five practices in a 30-practice pediatric primary care network are presented to illustrate how the logic model and evaluation plan have been used to guide the iterative process of program development. Results: A total of 4,619 office visits were completed during the two years of the pilot. Primary care clinicians were highly satisfied with the integrated primary care program and provided feedback on ways to further improve the program. Members of the primary care team and behavioral health providers rated the program as being relatively well integrated into the practices after the second year of the pilot. Conclusions: This logic model and evaluation plan provide a template for future projects integrating behavioral health services in non-specialty mental health settings, including pediatric primary care, and can be used broadly to provide structure to implementation and evaluation activities and promote replication of effective initiatives. Competing Interests: Declaring Conflicts of Interest: The authors have no conflicts of interest to declare.
Databáze:	MEDLINE
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