Integrated Care and the Evolution of the Multidisciplinary Team

Dobbins, Mary I.; Thomas, Sheila; Melton, Stacy L. Stokes; Lee, Stacy

doi:10.1016/j.pop.2016.01.003

Cited by 15 publications

(16 citation statements)

References 15 publications

(24 reference statements)

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“…In this context, behavioral and mental health services are being better integrated with primary care, and delivery as well as payment models are evolving to support improved public health via population health management. 75,76 Indeed, approaches such as iCBT are emblematic of this movement, representing a scalable approach that can be offered proximate to screening in the primary care office, to improve access, enhance outcomes and reduce cost. It remains to be determined which sub-populations of patients will be best suited for these versus alternative interventions, and which methods and amount of patient contact (e.g., brief weekly phone calls from iCBT staff providing encouragement, support and clarification of iCBT lesson content and homework) will best facilitate treatment adherence and completion.…”

Section: Future Directionsmentioning

confidence: 99%

Internet-Based Cognitive-Behavioral Therapy for Depression: Current Progress and Future Directions

Webb

Rosso

Rauch

2017

Harv Rev Psychiatry

191

114

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The World Health Organization (WHO) estimates that during a given 12-month period approximately 34 million people suffering from major depressive disorder go untreated in Europe and the Americas alone.1 Barriers to treatment include geographic distance, lack of mental health insurance, prohibitive cost of treatment, long wait-lists, and perceived stigma. Over the past two decades internet-based cognitive behavioral therapy (iCBT) programs have proliferated. A growing body of research supports the efficacy of iCBT for depression and other psychiatric conditions, and these programs may help address barriers that hinder access to effective treatment. The present review describes common iCBT programs along with the evidence base supporting their efficacy in reducing symptoms of depression, reviews research on moderators of treatment response, and provides suggestions for future directions in research and care.

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Section: Future Directionsmentioning

confidence: 99%

Internet-Based Cognitive-Behavioral Therapy for Depression: Current Progress and Future Directions

Webb

Rosso

Rauch

2017

Harv Rev Psychiatry

191

114

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“…[17][18][19] Integrated care approaches typically apply multidisciplinary teams to address the medical and nonmedical issues that patients with common behavioral health conditions face in a variety of ways. 20 When a face-to-face visit with a psychiatrist is indicated, however, most integrated care models still require a patient to schedule this appointment in advance and keep it. A notable exception may be the use of an asynchronous virtual encounter.…”

mentioning

confidence: 99%

A Successful Walk-In Psychiatric Model for Integrated Care

et al. 2019

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Accommodating walk-in psychiatry visits in primary care can improve access to psychiatric care for patients from historically underserved groups. We sought to determine whether a walk-in psychiatry model embedded within an integrated care practice could be sustained over time, and to characterize the patients who accessed care through it. Methods: We reviewed electronic health records linked to 811 psychiatry encounters in an integrated care practice between October 1, 2015 and September 30, 2017. Primary outcomes were the initial and return psychiatry encounters per month. Secondary outcomes were the demographics and diagnoses of patients who accessed their initial visits through walk-in sessions and scheduled appointments. Results: 490 initial psychiatry evaluations and 321 return encounters took place over the 2-year study period. The volume of initial psychiatry evaluations per month did not significantly change, but the volume of psychiatry follow-up encounters significantly increased after the walk-in session expanded. Medicaid recipients (OR, 1.9; 95% CI, 1.2 to 3.0); individuals without a college degree (OR, 1.7; 95% CI, 1.1 to 2.5); individuals who were single, divorced, or separated (OR, 1.7; 95% CI, 1.1 to 2.5); and individuals who identified as Black or Hispanic (OR, 2.5; 95% CI, 1.7 to 3.6) were more likely to access an initial psychiatry evaluation through a walk-in session as opposed to a scheduled appointment. Conclusions: Providing psychiatric care on a walk-in basis in integrated care is sustainable. Patients from historically underserved groups may access psychiatric care disproportionately through a walk-in option when it is available.

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“…The geographical distance between the FHS and the area covered is considered as restrictive for teamwork, as it generates more time spent for the displacement of professionals, which reduces the number of home visits. FHS units should be located in regions that allow greater proximity to users (DOBBINS et al, 2016), otherwise this may compromise the performance of the work as well as the possibility of a more collective and integrated.…”

Section: Discussionmentioning

confidence: 99%

Restrictive and driving factors for teamwork in primary health care

et al. 2020

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To identify, from the professionals' perspective, restrictive and driving factors for teamwork, in the Family Health Strategy. Descriptive study / qualitative approach, carried out with a Family Health Strategy team, in a municipality in the interior of Minas Gerais. Population constituted of nine professionals working in the team for at least six months, interviewed in August / 2016. Data analysis followed content analysis, thematic modality. Nine professionals participated: six community health agents, one physician, one dentist and one oral health aide. The results that emerged from the interviews were grouped by content affinity, in four thematic units, of which two referred to difficulties (restrictive factors) and two, to facilities (driving factors) for teamwork. Restrictive factors for teamwork were included in thematic units: Inadequate organization and resources and weakened interpersonal relationships. It has been shown that inadequate organization / resources and fragile interpersonal relationships restrict and limit teamwork in the Family Health Strategy. The driving factors for teamwork were gathered in thematic units: In-service training and interpersonal relationships based on appropriate collaboration and communication. It was verified that in-service training and interpersonal relationship, based on collaboration, mutual aid and communication, impelled the said teamwork. Both the restrictive and the driving factors for teamwork are linked to the conditions for carrying out the work and the relationship between team agents. The evidence found in this research can lead to advances in organizational behavior, with emphasis on management practices aimed at ensuring and supporting the effective development of the teamwork modality

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Integrated Care and the Evolution of the Multidisciplinary Team

Cited by 15 publications

References 15 publications

Internet-Based Cognitive-Behavioral Therapy for Depression: Current Progress and Future Directions

Internet-Based Cognitive-Behavioral Therapy for Depression: Current Progress and Future Directions

A Successful Walk-In Psychiatric Model for Integrated Care

Restrictive and driving factors for teamwork in primary health care

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