Integrated care is widely accepted as an evidence-informed strategy aimed at improving whole-person health. Positive outcomes have been demonstrated at patient, clinic, and systems level. Healthcare landscape, major healthcare reforms seek to modify billing, health information technology, and the workforce, among other change initiatives are shifting towards integrated care models. Through this rapid decade of growth, many clinics have nurtured flourishing integrated healthcare programs. However, some clinics have struggled to maintain or grow the program after the initial funding has evaporated, in spite of positive outcomes and a general sense of satisfaction with the programs. To optimize the uptake and progression towards sustainability, we can assess and amend organizational factors that are known to support the use of the innovation. This is known as implementation science. Focusing on implementation and capacity building for scale-up across an organization increases the chances that an evidence-based program, practice or policy (EBP) will be delivered with integrity and will achieve intended outcomes. The time it takes from research to move from trial to full implementation can be reduced from 17 years to about three years when implementation best practices are delivered via technical assistance. Organizations optimize their outcomes when they: 1) Build organizational readiness for an initiative, 2) explore and build necessary capacities to support the use of a new innovation, and 3) allocate time and effort to adequately attend to programmatic elements that will result in systematization and its precursor, routinzation -key elements in sustainability. Medical settings often have implementation needs that are unique to their context, such as capacity for informatics and health information technology, workflow analysis, and attention to billing and coding. The implementation of integrated healthcare programming is even more complex. Beyond these technical components, clinics must first shift their culture toward the foundational tenants of team-based approaches to treatment and patient-centered care while simultaneously selecting a programmatic model and fully operationalizing that model. Therefore, one must choose the approach (e.g., Primary Care Behavioral Health Model or Collaborative Care Model) and clinical foci and related practice modalities (e.g., ADHC clinic, socioemotional screening and brief intervention, brief anxiety treatment, healthy weight clinic) that is the best fit for their clinic. There is some literature on implementation strategies related to integrated care implementation. However, there is a growing base of best practices, many of which are program agnostic. In this session, we will compile and share lessons learned across the fields of implementation science and integrated care. We will also provide tangible strategies learned from the presenters’ experience providing technical assistance to organizations.
- Describe ten implementation best practice strategies they can use to promote sustainability of their integrated care program
- Describe the crossover among implementation strategies, effectiveness research, and quality improvement
- Apply one or two applied implementation strategies that promote programmatic uptake or sustainability