Presenters
- Karen Colorafi, PhD, RN, School of Nursing and Human Physiology, Gonzaga University, Spokane, WA
- David Bauman, PsyD, Behavioral Health Education Director, Community Health of Central Washington, Yakima, WA
- Gina Many, MD, Medical Educator, Community Health of Central Washington, Yakima, WA
- Rodger Kessler, PhD, ABPP, Associate Professor, University of Colorado School of Medicine, Aurora, CO
Summary
Background/rationale: The use of integrative models of care represent best practice for the treatment of anxiety and depression among primary care patients of all ages and with minority populations. Integrated models of care improve coping strategies and adherence to medications, which may in turn improve a variety of outcomes associated with the burden of chronic disease. Patients report improved satisfaction with access to integrated care in the primary care settings with which they are already familiar. Providers also report significant improvements in satisfaction related to access, quality, and continuity of care. The purpose of this evaluation was to assess provider satisfaction with an integrated behavioral health clinic (BHC) situated within a rural primary healthcare clinic. This abstract represents a work in progress; outcomes related to patient satisfaction and the management of Type II Diabetes will be included in Oct. Description of population sampled: Over a six-year period, responses to an annual provider satisfaction survey (n=244) were included in a dataset. Descriptive analysis confirms that respondents were representative of the clinic’s provider population. All provider types (including part-time) were included. Study design: A retrospective, observational study design was utilized to examine pre-existing, de-identified data using the RE-AIM framework. Procedures and measures used: Data were complied by clinic staff and shared with independent researchers for analysis. A variety of objectively measured outcomes were assessed according to the RE-AIM framework (Reach: baseline characteristics of cohorts, Effectiveness: satisfaction, Adoption: program utilization, Implementation: qualitative report of adaptations over time, Maintenance: trending scores, staffing plan) and will be presented. Provider satisfaction was assessed with a clinic-authored scale that met criteria for face validity and has been used consistently over a five-year period. Key Results: Between 2016 and 2021, 244 surveys were included in the initial analysis of provider satisfaction. Sixty four percent of respondents were female. Respondents represented all provider types: 52% MD, 30% DO, 9% NP, 9% PA. The vast majority of providers (98%, n=235) were highly satisfied with the integrated services, and 74% (n=177) thought the services were extremely helpful to their patients. 85% (n=202) thought that patients were better able to manage medication regimens after seeing BHC. 96% (n=231) thought that having the BHC made their job easier. Recommendations for improvement included back-to-back scheduling to facilitate co-visits, hiring more staff for faster access, and offering Spanish-speaking counsellors. Respondent explained that the benefit of having a BHC was being able to “off load interventions I am not very good at to someone who is.” Conclusions: The integration of a BHC within a rural family practice was highly satisfying to primary care providers.
Objectives
- Identify the degree of satisfaction of primary care providers with an integrated behavioral health clinic.
- Describe the reasons that primary care patients find an integrated behavioral health clinic helpful in managing chronic conditions.
- Discuss the value of integrated behavioral health care to the achievement of key metrics for reportable T2DM measures.
