Partnering with health system operations leadership to develop a controlled implementation trial.

Area of Science:

• Implementation Science
• Health Services Research
• Mental Health Services

Background:

• Mental health condition outcomes are often suboptimal due to fragmented care.
• Collaborative Chronic Care Models (CCMs) show promise in improving outcomes for various mental health conditions.
• The US Department of Veterans Affairs initiated a national effort to implement multidisciplinary teams in general mental health clinics.

Purpose of the Study:

• To evaluate the successful implementation of evidence-based CCMs using existing staff.
• To determine the impact of CCM implementation on patient health status and care perceptions.
• To address operational priorities and scientific rigor in health system change.

Main Methods:

• A hybrid type III stepped-wedge design with nine study sites.
• Implementation support utilizing the CDC's Replicating Effective Programs strategy, supplemented by facilitation.
• Quantitative (fidelity, patient health outcomes; n=765) and qualitative (provider interviews) data collection and analysis.

Main Results:

• The study is ongoing, with data collection and analysis in progress.
• Formative evaluation focuses on recipients, context, innovation, and facilitation.
• Summative evaluation combines quantitative and qualitative outcome measures.

Conclusions:

• Jointly designed, controlled protocols enhance the likelihood of answering critical operational questions rigorously.
• This approach facilitates sustainable change within the healthcare system.
• Implementation research is crucial for optimizing mental health service delivery.