H06 – IPC at the Vanguard of Value: A Continuous Quality Improvement Approach to Primary Care Behavioral Health Services in Medical Education

Summary

The Primary Care Behavioral Health (PCBH) model continues to garner support and acclaim, and has demonstrated vast potential for not only mental health but also physical health related outcomes. Contemporary focus on PCBH has begun to shift toward the identification of operational efficiencies and the testing of best practice applications in a variety of settings. The purpose of this presentation is to explicate such elements from a unique PCBH model positioned in the context of a medical education setting, linked to HEIDS quality health outcomes, and which is using a continuous quality improvement (CQI) format to provide further innovation. This presentation will specifically explore core components of the project including the inception of an integrated primary care taskforce using Kotter’s 8-Step Change Model, strategies for service evaluation that have linked behavioral interventions to physical health metrics, and examination of new directions in the context of value and time driven activity based costing methods (TDABC). To begin, the presentation will set the context for how PCBH was developed in the novel environment of an internal medicine residency clinic via use of an IPC taskforce. This taskforce utilized models from the business world to expand the work of existing health system’s IPC efforts. Briefly, we will delineate the Kotter’s 8-Step Change Model and discuss how this successfully impacted the framework of our PCBH services. Second, the focus of the presentation will turn to the specific CQI principles employed and the aim of linking health outcomes and IPC interventions. The project included a standard screening process, and provided a number of opportunities to compare pre and post intervention data. Metrics of interest in the presentation will explore readiness to change scores, the iterative effects of PCBH related to successive visits, and comparisons of top physical health outcomes as connected to HEIDs quality metrics and IPC. Concluding, this presentation will highlight developing initiatives for the CQI project including the value stream components of IPC in the education setting. Highlights of this section will explore efforts to utilized contemporary costing strategies such as TDABC, examining value associated with prospective revenue capture, and map both upstream and downstream costs savings.