title: Using Quality Improvement to Increase Access to Behavioral Health Care in Federally Qualified Health Centers.
abstract: OBJECTIVE
  Integrated care programs, in which behavioral health is integrated in primary care settings, have been widely implemented as solution to rising health care expenditures. A number of recommendations for implementation of integrated care have been published in the past decade; however, data regarding how to produce the most effective system are lacking. This may be because of the fact that existing integrated care programs do not institute quality improvement initiatives that could generate this needed data.
  
  
  METHODS
  A quality improvement program was instituted at an integrated Federally Qualified Health Center. As a result, productivity and no-show rates were analyzed for two psychology externs providing integrated care services. A process map was created to identify systematic methods to improve outcomes.
  
  
  RESULTS
  There were statistically significant increases to productivity increased and decreases no-show rates through systematic changes.
  
  
  CONCLUSIONS
  This case study provides evidence that quality improvement systems in integrated care can result in systemic changes that improve access to care.
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD, USA al.maragakis@hotmail.com.
authors.forename: Alexandros
authors.initials: A
authors.lastname: Maragakis
authors.affiliation: University of Nevada, Reno, NV, USA.
authors.forename: Cassandra
authors.initials: C
authors.lastname: Snipes
authors.affiliation: Community Health Alliance, Reno, NV, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Mazzucotelli
authors.affiliation: Community Health Alliance, Reno, NV, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Duarte
mesh_terms: D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D058996:Quality Improvement; D012189:Retrospective Studies; D014481:United States
keywords: access to care; community health centers; efficiency; program evaluation; quality improvement