title: Staff perceptions implementing interprofessional team-based behavioural healthcare.
abstract: The US Veterans Health Administration (VHA) in 2013 mandated a nationwide implementation of interprofessional team-based care in the general mental health setting and officially endorsed the collaborative care model in 2015 to guide the coordinated and anticipatory care to be delivered by these teams. Front-line clinic staff are major stakeholders whose practices are most directly affected by this implementation and may or may not view teams as useful or feasible for their practice. Our objective was to examine their perspectives on delivering team-to-patient care in order to understand what system-level efforts can best support the transition to such care from the more conventional provider-to-patient care. We conducted 14 semi-structured interviews with staff from general mental health clinics across three different VHA medical facilities. The interview questions focused on asking how care is organised and delivered at their clinic, their experiences in collaborating with other staff, and how the clinic handles changes. Four recurrent themes were identified: navigating workplace supervision, organisation, and role structures; continuing professional growth and relationships; delivering patient-focused care through education and connection to resources; and utilising information technology for communication and panel-based management. Quality improvement efforts were rarely discussed during the interviews. Our results indicate that staff's endorsement of the implementation of interprofessional care teams in general mental health settings may be strengthened through associated efforts targeted at enhancing their experiences aligned to these emergent themes.
authors.affiliation: a VA Health Services Research & Development Center for Healthcare Organization and Implementation Research , Boston , Massachusetts , USA.|b Harvard Medical School , Boston , Massachusetts , USA.
authors.forename: Bo
authors.initials: B
authors.lastname: Kim
authors.affiliation: a VA Health Services Research & Development Center for Healthcare Organization and Implementation Research , Boston , Massachusetts , USA.|b Harvard Medical School , Boston , Massachusetts , USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Miller
authors.affiliation: a VA Health Services Research & Development Center for Healthcare Organization and Implementation Research , Boston , Massachusetts , USA.|c Boston University School of Public Health , Boston , Massachusetts , USA.
authors.forename: A Rani
authors.initials: AR
authors.lastname: Elwy
authors.affiliation: a VA Health Services Research & Development Center for Healthcare Organization and Implementation Research , Boston , Massachusetts , USA.|c Boston University School of Public Health , Boston , Massachusetts , USA.
authors.forename: Sally K
authors.initials: SK
authors.lastname: Holmes
authors.affiliation: d VA New England Healthcare System (Veterans Integrated Services Network 1) , Bedford , Massachusetts , USA.|e Boston University School of Medicine , Boston , Massachusetts , USA.
authors.forename: Craig M
authors.initials: CM
authors.lastname: Coldwell
authors.affiliation: a VA Health Services Research & Development Center for Healthcare Organization and Implementation Research , Boston , Massachusetts , USA.|b Harvard Medical School , Boston , Massachusetts , USA.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Bauer
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities / Q000458:organization & administration; D000071959:Case Managers / Q000523:psychology*; D003142:Communication; D003299:Cooperative Behavior; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D007857:Leadership; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration*; D018802:Patient-Centered Care / Q000458:organization & administration; D010465:Perception; D058007:Physicians, Primary Care / Q000523:psychology*; D011320:Primary Health Care / Q000458:organization & administration; D036301:Qualitative Research; D058996:Quality Improvement; D012959:Socioeconomic Factors; D035502:Trust; D014481:United States; D014493:United States Department of Veterans Affairs
keywords: Collaborative care model grounded thematic analysis; implementation; interprofessional teamwork; interviews; team-based care