Barriers to Clinical Practice

Access to care along with a shortage of healthcare providers, especially psychiatric specialists is a widespread problem in many areas of Virginia. Patients who have 1 or more chronic illnesses frequently have coexisting psychiatric problems, and psychiatric patients often have at least 1 chronic health condition. To assist in addressing both behavioral health and primary care services for health promotion and disease prevention, a collaborative care model as outlined by the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration was evaluated. The collaborative care model was compared with existing services and barriers to health care identified in a rural Virginia County. Identification and use of advanced practice nursing roles and improved collaboration among health care providers were emphasized. Evidence-based practice interventions and quality improvement strategies such as the plan-do-check-act model were identified and evaluated. Outcome measures outlining an evaluation plan for goals related to improving health outcomes were identified with recommendations for various accessible wellness programs.