title: Implementation of illness management and recovery in the Veterans Administration: an on-line survey.
abstract: OBJECTIVE
  This study explores the implementation of illness management and recovery (IMR) across Veterans Affairs Medical Centers (VAMCs). The implementation of illness management programming has been mandated in certain programs within VAMCs. IMR is consistent with the Department of Veteran Affairs (VA) emphasis on recovery-oriented, evidence-based treatments. This study examines both the penetration of IMR within the VA system and the barriers and facilitators to implementation.
  
  
  METHODS
  An online survey was sent to local recovery coordinators, who, in turn, identified other local IMR experts.
  
  
  RESULTS
  Respondents from 107 clinics (representing 101 VAMCs) answered the survey. Less than half of VAMCs provide IMR services. Psychosocial Rehabilitation and Recovery Centers (PRRC), which specialize in services for Veterans with psychiatric disabilities, are more likely to provide IMR; however, more than one third do not. Few respondents had access to IMR implementation tools such as training, consultation, or fidelity monitoring. Only about one fifth of IMR providers have been trained in IMR. Respondents reported several facilitators to implementation, such as knowledgeable staff members and peer support. Common barriers to implementation included limited staff availability and "intimidating" workbook materials.
  
  
  CONCLUSIONS
  The VA is well underway in its implementation of IMR; however, there is room for expansion. Implementation tools such as training and consultation are needed to ensure dissemination and quality within VA. Given the comparative resources and infrastructure of VA, it is likely that equal or greater implementation tools are necessary in other systems of care.
authors: Health Services Research and Development, Richard L. Roudebush Veterans Affairs Medical Center.
authors: Alan B
authors: AB
authors: McGuire
authors: Dominique A
authors: DA
authors: White
authors: Laura M
authors: LM
authors: White
authors: Michelle P
authors: MP
authors: Salyers
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D004059:Diffusion of Innovation; D055317:Evidence-Based Practice; D019538:Health Care Surveys; D006284:Health Plan Implementation / Q000706:statistics & numerical data*; D006801:Humans; D001523:Mental Disorders / Q000534:rehabilitation*; D008605:Mental Health Services / Q000458:organization & administration*; D012046:Rehabilitation / Q000379:methods* / Q000458:organization & administration / Q000592:standards; D012047:Rehabilitation Centers / Q000592:standards / Q000706:statistics & numerical data*; D012648:Self Care / Q000379:methods; D014481:United States; D014493:United States Department of Veterans Affairs