Explication of a Behavioral Health-Primary Care Integration Learning Collaborative and Its Quality Improvement Implications
In an effort to tackle fragmented care in the US healthcare delivery system, we explored the use of learning collaborative (LC) to advance integration of behavioral health and primary care as one of the potential solutions to a holistic approach to the delivery of quality healthcare to individuals with physical and mental illness. How a diverse group of primary care and behavioral health providers formed a Community of Practice (CoP) with a common purpose and shared vision to advance integrated care using a LC approach is described. An account of their learning experience, key components of their quality improvement, practice changes, clinical processes, and improved outcomes are explained. This paper aims at describing the history, creative design, processes, roles of the CoP and impact of the LC on the advancement of integrated care practice and quality improvements for further exploration and replications.
KeywordsLearning collaborative Community of practice Integration of behavioral health and primary care Quality improvement
Integrated Care Practice Change and Quality Improvement (ICPCQI) initiative was funded by Grants from Kaiser Permanente and Georgia State Department of Behavioral Health and Developmental Disabilities (DBHDD). We thank the patients, staff, and providers at Asa G. Yancey Health Center, Mercy Care Services, Neighborhood Union Health Center, North Fulton Service Center, Cobb County Community Service Board (CSB) and McIntosh Trail CSB for their participation in the Learning Community and ICPCQI.
Compliance with Ethical Standards
Conflict of interest
There are no commercial associations that might pose a conflict of interest in connection with this manuscript. All authors certified responsibility for the study.
- Aronson, E., Blaney, N., Stephan, C., Sikes, J., & Snapp, M. (1978). The jigsaw classroom. Beverley Hills, CA: Sage.Google Scholar
- Burns, J. M. (1978). Leadership. New York: Harper & Row.Google Scholar
- Dillenbourg, P. (1999). Collaborative learning: Cognitive and computational approaches. Advances in learning and instruction series. New York, NY: Elsevier Science, Inc.Google Scholar
- Ebert, L., Amaya-Jackson, L., Markiewicz, J. M., Kisiel, C., & Fairbank, J. A. (2011). Use of the breakthrough series collaborative to support broad and sustained use of evidence-based trauma treatment for children in community practice settings. Administration and Policy in Mental Health and Mental Health Services Research, 39(3), 187–199.CrossRefGoogle Scholar
- Ede, V., Okafor, M., Kinuthia, R., Belay, Z., Teclemichael, T., Alema-Mensah, E., et al. (2015). An examination of perceptions in integrated care practice. Community Mental Health.Google Scholar
- Epstein, J. N., Langberg, J. M., Lichtenstein, P. K., Altaye, M., Brinkman, W. B., House, K., & Stark, L. J. (2010). Attention-deficit/hyperactivity disorder outcomes for children treated in community-based pediatric settings. Archives of Pediatrics & Adolescent Medicine, 164(2), 160–165.CrossRefGoogle Scholar
- Klein, S., & Hostetter, M. (2014). In focus: Integrating behavioral health and primary care. The Commonwealth Fund, Retrieved from http://www.commonwealthfund.org/publications/newsletters/quality-matters/2014/august-september/in-focus.
- Kohn, R. (2014). Trends, gaps, and disparities in mental health. In S. O. Okpaku (Ed.) Essentials of global mental health (pp. 27–38). Cambridge: Cambridge University Press.Google Scholar
- Minkman, M., Schouten, L., Huijsman, R., & Splunteren, P. V. (2005). Integrated care for patients with a stroke in the Netherlands: Results and experiences from a National breakthrough collaborative improvement project. International Journal of Integrated Care. https://doi.org/10.5334/ijic.118
- Morehouse School of Medicine. The Satcher Health Leadership Institute. (2015). Division of Behavioral Health, Behavioral Health Integration Demonstration Project Report. Retrieved Aug 11, 2015 from http://www.msm.edu/Research/research_centersandinstitutes/SHLI/aboutUs/behavioralhealth/abo utus.php.
- Morrissey, J. P., Domino, M., Wicher, C., Kilany, M., Gaynes, B. (2009). Integrating primary care and mental health services: Final evaluation report on the ICARE integration pilot sites. Chapel Hill: University of North Carolina at Chapel Hill.Google Scholar