Integrated care clinic: Creating enhanced clinical pathways for integrated behavioral health care in a family medicine residency clinic serving a low-income, minority population

Jerica M Berge, Lisa Trump, Stephanie Trudeau, Damir S. Utržan, Michele Mandrich, Andrew H Slattengren, Tanner J Nissly, Laura Miller, Macaran A Baird, Eli Coleman, Michael R Wootten

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Introduction: Research examining the implementation and effectiveness of integrated behavioral health (BH) care in family medicine/primary care is growing. However, research identifying ways to consistently use integrated BH in busy family medicine/primary care settings with underserved populations is limited. This study describes 1 family medicine clinic's transformation into a fully integrated BH care clinic through the development of an Integrated Care Clinic (ICC) and enhanced clinical pathways to promote regular use of behavioral health clinicians (BHCs). Method: We implemented the ICC at the Broadway Family Medicine Clinic serving a low-income (<$25,000 annual income/year) and minority population (>70% African American) in Minnesota. We conducted a pre- and postevaluation of the ICC during regular clinic activity. Results: Pilot findings indicated that the creation of ICC and the use of enhanced clinical pathways (e.g., 5-2-1-0 obesity prevention messages, Transitional Care Management, postpartum depression screening visits, warm hand-offs) to facilitate regular use of integrated BH care resulted in 6 integrated care visits per BHC per clinic half-day. In addition, changes in the behavioral/mental health therapy appointment time slot (from 60 to 30 min) reduced therapy no-show rates. Transitional Care Management (TCM) visits also showed improved pre- and postchanges in patient and clinician satisfaction and reductions in patient hospital readmission rates. Discussion: The transformation into a fully integrated BH family medicine clinic through the creation of ICC and enhanced clinical pathways to facilitate regular integrated BH care showed promising pilot results. Future research is needed to examine associations between ICC and patient outcomes (e.g., weight, depressive symptoms).

Original languageEnglish (US)
Pages (from-to)283-294
Number of pages12
JournalFamilies, Systems and Health
Volume35
Issue number3
DOIs
StatePublished - Sep 2017

Fingerprint

Critical Pathways
Poverty
Internship and Residency
Medicine
Delivery of Health Care
Patient Readmission
Primary Health Care
Health
Postpartum Depression
Family Health
Vulnerable Populations
Ambulatory Care Facilities
Patient Satisfaction
Research
African Americans
Patient Care
Appointments and Schedules
Mental Health
Hand
Obesity

Keywords

  • Behavioral health
  • Family medicine
  • Integrated care
  • Low-income
  • Minority

Cite this

Integrated care clinic : Creating enhanced clinical pathways for integrated behavioral health care in a family medicine residency clinic serving a low-income, minority population. / Berge, Jerica M; Trump, Lisa; Trudeau, Stephanie; Utržan, Damir S.; Mandrich, Michele; Slattengren, Andrew H; Nissly, Tanner J; Miller, Laura; Baird, Macaran A; Coleman, Eli; Wootten, Michael R.

In: Families, Systems and Health, Vol. 35, No. 3, 09.2017, p. 283-294.

Research output: Contribution to journalArticle

@article{6924d00e4e0d46859aa6ec7a7546c1d1,
title = "Integrated care clinic: Creating enhanced clinical pathways for integrated behavioral health care in a family medicine residency clinic serving a low-income, minority population",
abstract = "Introduction: Research examining the implementation and effectiveness of integrated behavioral health (BH) care in family medicine/primary care is growing. However, research identifying ways to consistently use integrated BH in busy family medicine/primary care settings with underserved populations is limited. This study describes 1 family medicine clinic's transformation into a fully integrated BH care clinic through the development of an Integrated Care Clinic (ICC) and enhanced clinical pathways to promote regular use of behavioral health clinicians (BHCs). Method: We implemented the ICC at the Broadway Family Medicine Clinic serving a low-income (<$25,000 annual income/year) and minority population (>70{\%} African American) in Minnesota. We conducted a pre- and postevaluation of the ICC during regular clinic activity. Results: Pilot findings indicated that the creation of ICC and the use of enhanced clinical pathways (e.g., 5-2-1-0 obesity prevention messages, Transitional Care Management, postpartum depression screening visits, warm hand-offs) to facilitate regular use of integrated BH care resulted in 6 integrated care visits per BHC per clinic half-day. In addition, changes in the behavioral/mental health therapy appointment time slot (from 60 to 30 min) reduced therapy no-show rates. Transitional Care Management (TCM) visits also showed improved pre- and postchanges in patient and clinician satisfaction and reductions in patient hospital readmission rates. Discussion: The transformation into a fully integrated BH family medicine clinic through the creation of ICC and enhanced clinical pathways to facilitate regular integrated BH care showed promising pilot results. Future research is needed to examine associations between ICC and patient outcomes (e.g., weight, depressive symptoms).",
keywords = "Behavioral health, Family medicine, Integrated care, Low-income, Minority",
author = "Berge, {Jerica M} and Lisa Trump and Stephanie Trudeau and Utržan, {Damir S.} and Michele Mandrich and Slattengren, {Andrew H} and Nissly, {Tanner J} and Laura Miller and Baird, {Macaran A} and Eli Coleman and Wootten, {Michael R}",
year = "2017",
month = "9",
doi = "10.1037/fsh0000285",
language = "English (US)",
volume = "35",
pages = "283--294",
journal = "Families, Systems and Health",
issn = "1091-7527",
publisher = "American Psychological Association",
number = "3",

}

TY - JOUR

T1 - Integrated care clinic

T2 - Creating enhanced clinical pathways for integrated behavioral health care in a family medicine residency clinic serving a low-income, minority population

AU - Berge, Jerica M

AU - Trump, Lisa

AU - Trudeau, Stephanie

AU - Utržan, Damir S.

AU - Mandrich, Michele

AU - Slattengren, Andrew H

AU - Nissly, Tanner J

AU - Miller, Laura

AU - Baird, Macaran A

AU - Coleman, Eli

AU - Wootten, Michael R

PY - 2017/9

Y1 - 2017/9

N2 - Introduction: Research examining the implementation and effectiveness of integrated behavioral health (BH) care in family medicine/primary care is growing. However, research identifying ways to consistently use integrated BH in busy family medicine/primary care settings with underserved populations is limited. This study describes 1 family medicine clinic's transformation into a fully integrated BH care clinic through the development of an Integrated Care Clinic (ICC) and enhanced clinical pathways to promote regular use of behavioral health clinicians (BHCs). Method: We implemented the ICC at the Broadway Family Medicine Clinic serving a low-income (<$25,000 annual income/year) and minority population (>70% African American) in Minnesota. We conducted a pre- and postevaluation of the ICC during regular clinic activity. Results: Pilot findings indicated that the creation of ICC and the use of enhanced clinical pathways (e.g., 5-2-1-0 obesity prevention messages, Transitional Care Management, postpartum depression screening visits, warm hand-offs) to facilitate regular use of integrated BH care resulted in 6 integrated care visits per BHC per clinic half-day. In addition, changes in the behavioral/mental health therapy appointment time slot (from 60 to 30 min) reduced therapy no-show rates. Transitional Care Management (TCM) visits also showed improved pre- and postchanges in patient and clinician satisfaction and reductions in patient hospital readmission rates. Discussion: The transformation into a fully integrated BH family medicine clinic through the creation of ICC and enhanced clinical pathways to facilitate regular integrated BH care showed promising pilot results. Future research is needed to examine associations between ICC and patient outcomes (e.g., weight, depressive symptoms).

AB - Introduction: Research examining the implementation and effectiveness of integrated behavioral health (BH) care in family medicine/primary care is growing. However, research identifying ways to consistently use integrated BH in busy family medicine/primary care settings with underserved populations is limited. This study describes 1 family medicine clinic's transformation into a fully integrated BH care clinic through the development of an Integrated Care Clinic (ICC) and enhanced clinical pathways to promote regular use of behavioral health clinicians (BHCs). Method: We implemented the ICC at the Broadway Family Medicine Clinic serving a low-income (<$25,000 annual income/year) and minority population (>70% African American) in Minnesota. We conducted a pre- and postevaluation of the ICC during regular clinic activity. Results: Pilot findings indicated that the creation of ICC and the use of enhanced clinical pathways (e.g., 5-2-1-0 obesity prevention messages, Transitional Care Management, postpartum depression screening visits, warm hand-offs) to facilitate regular use of integrated BH care resulted in 6 integrated care visits per BHC per clinic half-day. In addition, changes in the behavioral/mental health therapy appointment time slot (from 60 to 30 min) reduced therapy no-show rates. Transitional Care Management (TCM) visits also showed improved pre- and postchanges in patient and clinician satisfaction and reductions in patient hospital readmission rates. Discussion: The transformation into a fully integrated BH family medicine clinic through the creation of ICC and enhanced clinical pathways to facilitate regular integrated BH care showed promising pilot results. Future research is needed to examine associations between ICC and patient outcomes (e.g., weight, depressive symptoms).

KW - Behavioral health

KW - Family medicine

KW - Integrated care

KW - Low-income

KW - Minority

UR - http://www.scopus.com/inward/record.url?scp=85025170248&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85025170248&partnerID=8YFLogxK

U2 - 10.1037/fsh0000285

DO - 10.1037/fsh0000285

M3 - Article

C2 - 28737412

AN - SCOPUS:85025170248

VL - 35

SP - 283

EP - 294

JO - Families, Systems and Health

JF - Families, Systems and Health

SN - 1091-7527

IS - 3

ER -