A Learning Collaborative Approach to Improve Mental Health Service Delivery in Pediatric Primary Care
| Autor: | Courtney M. Brown, Divya Manda, Samantha Anzeljc, Melissa A. King, John C. Duby, Rebecca Baum |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Referral business.industry media_common.quotation_subject MEDLINE Multi-institutional collaborative and QI network research Collaborative learning Mental health 03 medical and health sciences 0302 clinical medicine Promotion (rank) Documentation 030225 pediatrics Family medicine medicine ComputingMethodologies_DOCUMENTANDTEXTPROCESSING Anxiety 030212 general & internal medicine medicine.symptom business Depression (differential diagnoses) media_common |
| Zdroj: | Pediatric Quality & Safety |
| ISSN: | 2472-0054 |
| Popis: | Supplemental Digital Content is available in the text. Background: Pediatric primary care practitioners (PPCPs) report inadequate training in the care of children with common mental health conditions. Although additional training is needed, system changes are also necessary to support improvements in care. Methods: We developed the Building Mental Wellness Learning Collaborative to assist PPCPs in delivering better mental health services in primary care by targeting 5 focus areas: mental health promotion; early identification and screening; practitioner skills; collaboration and community linkages; and medication management. Aims were developed for each area. Results: Twenty-one practices and 50 practitioners completed the collaborative in 2 seven-month waves. For mental health promotion, ≥85% of charts showed documentation in 3 of 4 preselected areas. For early identification/screening, screening increased, but the ≥85% goal was not met. For practitioner skills, a ≥20% increase in the proportion of children/youth ≥1 visits for anxiety or depression was achieved, from 0.70% of children/youth in the 12 months preintervention to 1.09% children/youth in the 12 months after. For collaboration/linkages, mental health referral completion was unchanged and below the 60% goal. For medication use, a ≥15% increase in selective serotonin reuptake inhibitor prescribing by Building Mental Wellness (BMW) practitioners was achieved from 0.72% children/youth with office visits pre-BMW to 0.92% post. Prescribing did not decrease for atypical antipsychotic medication use or for psychotropic medication use in children younger than 6 years, although there was a trend toward more appropriate prescribing. Conclusions: The BMW Learning Collaborative was effective in helping PPCPs implement certain aspects of a comprehensive approach to the delivery of mental health services in primary care. |
| Databáze: | OpenAIRE |
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