Advancing integrated care through cotraining of residents and psychology postdoctoral fellows.

Duggan, Mary; Bancroft, Courtney; Browder, Casey; Gorski, Victoria

doi:10.1037/fsh0000754

Cited by 1 publication

(1 citation statement)

References 6 publications

(7 reference statements)

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“…Even as interdisciplinary collaboration is being increasingly embraced as leading to better outcomes [ 40 , 41 ], such collaboration is widely understood to be challenging [ 42 ]. Clarifying different disciplines’ respective roles is a particularly difficult aspect of interdisciplinary collaboration [ 43 ], and trainings and collaborative experiences of many health care professionals are only recently starting to be more interdisciplinary [ 44 ]. Furthermore, in the case of CCM specifically, the care model does not come with a set of pre-decided exact care processes to be implemented; the core CCM elements are principles to align to, rather than step-by-step guides to follow.…”

Section: Discussionmentioning

confidence: 99%

Interdisciplinary behavioral health provider perceptions of implementing the Collaborative Chronic Care Model: an i-PARIHS-guided qualitative study

Kim

Sullivan

Drummond

et al. 2023

Implement Sci Commun

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Background The evidence-based Collaborative Chronic Care Model (CCM), developed to help structure care for chronic health conditions, comprises six elements: work role redesign, patient self-management support, provider decision support, clinical information systems, linkages to community resources, and organizational/leadership support. As the CCM is increasingly implemented in real-world settings, there is heightened interest in understanding specific influences upon implementation. Therefore, guided by the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework, we (i) identified innovation-, recipient-, context-, and facilitation-related influences on CCM implementation and (ii) assessed the influences’ relationship to each CCM element’s implementation. Methods Using semi-structured interviews, we examined interdisciplinary behavioral health providers’ experiences at nine VA medical centers that implemented the CCM. We used i-PARIHS constructs as a priori codes for directed content analysis, then analyzed the data for cross-coding by CCM element and i-PARIHS construct. Results Participants (31 providers) perceived the CCM innovation as enabling comprehensive care but challenging to coordinate with existing structures/procedures. As recipients, participants recounted not always having the authority to design CCM-consistent care processes. They perceived local leadership support to be indispensable to implementation success and difficult to garner when CCM implementation distracted from other organizational priorities. They found implementation facilitation helpful for keeping implementation on track. We identified key themes at the intersection of i-PARIHS constructs and core CCM elements, including (i) the CCM being an innovation that offers a formal structure to stepping down care intensity for patients to encourage their self-management, (ii) recipients accessing their multidisciplinary colleagues’ expertise for provider decision support, (iii) relationships with external services in the community (e.g., homelessness programs) being a helpful context for providing comprehensive care, and (iv) facilitators helping to redesign specific interdisciplinary team member roles. Conclusions Future CCM implementation would benefit from (i) facilitating strategic development of supportive maintenance plans for patients’ self-management, (ii) collocating multidisciplinary staff (on-site or virtually) to enhance provider decision support, (iii) keeping information on available community resources up to date, and (iv) making clearer the explicit CCM-consistent care processes that work roles can be designed around. This work can inform concrete tailoring of implementation efforts to focus on the more challenging CCM elements, which is crucial to better account for multiple influences that vary across diverse care settings in which the CCM is being implemented.

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Section: Discussionmentioning

confidence: 99%