Using organizational change strategies to guide peer support technician implementation in the Veterans Administration.
OBJECTIVE
The Veterans Administration (VA) mental health system is in the process of hiring "Peer Support Technicians" or PSTs-individuals in recovery from serious mental illnesses hired as clinical team members. The purpose of this article is to demonstrate an implementation process that has potential to improve the deployment of the Peer Support Technicians to existing clinical teams within the VA.


METHODS
As part of a larger randomized trial called PEers Enhancing Recovery (PEER), research staff collaboratively planned the deployment of PSTs with three case management teams serving those with serious mental illnesses. Clinical staff received significant opportunity to participate in defining the PST role. PEER staff took extensive notes during planning meetings about the discussions held and decisions made about the PST role.


RESULTS
PEER and clinical staff discussed and came to a consensus on several elements that comprise the PST job including goals for employing PSTs, desired characteristics of PSTs, job duties, training to be provided to PSTs, PST access to medical records, supervision, boundaries, confidentiality, how PSTs are to discuss their mental illness with veterans, and a sick leave policy.


CONCLUSIONS
It is critical to solicit and use input from team providers and leaders when establishing PST services. This approach using input and solicitation can be a model to implement a wide range of clinical interventions in which existing providers and teams will be asked to do something new.
Chinman
Matthew
M
RAND Corporation, Health Pittsburgh VA Healthcare System, VISN 4 MIRECC, Pittsburgh, PA 15213-2665, USA. chinman@rand.org
Shoai
Rebecca
R
Cohen
Amy
A
D019090:Case Management / Q000458:organization & administration; D032921:Consensus; D006284:Health Plan Implementation / Q000458:organization & administration*; D006302:Health Services Research; D006801:Humans; D007318:Inservice Training; D001523:Mental Disorders / Q000523:psychology / Q000534:rehabilitation*; D009936:Organizational Innovation; D010348:Patient Care Team / Q000458:organization & administration*; D010379:Peer Group; D010560:Personnel Selection; D011618:Psychotic Disorders / Q000523:psychology / Q000534:rehabilitation*; D012944:Social Support; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration*; D014728:Veterans / Q000523:psychology*