Article

Innovations in mental health services implementation: a report on state-level data from the U.S. Evidence-Based Practices Project

VA Center for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Healthcare System, Sepulveda, California, USA.
Implementation Science (Impact Factor: 3.47). 02/2006; 1:13. DOI: 10.1186/1748-5908-1-13
Source: PubMed

ABSTRACT The Evidence-Based Practice (EBP) Project has been investigating the implementation of evidence-based mental health practices (Assertive Community Treatment, Family Psychoeducation, Integrated Dual Diagnosis Treatment, Illness Management and Recovery, and Supported Employment) in state public mental health systems in the United States since 2001. To date, Project findings have yielded valuable insights into implementation strategy characteristics and effectiveness. This paper reports results of an effort to identify and classify state-level implementation activities and strategies employed across the eight states participating in the Project.
Content analysis and Greenhalgh et al's (2004) definition of innovation were used to identify and classify state-level activities employed during three phases of EBP implementation: Pre-Implementation, Initial Implementation and Sustainability Planning. Activities were coded from site visit reports created from documents and notes from key informant interviews conducted during two periods, Fall 2002-Spring 2003, and Spring 2004. Frequency counts and rank-order analyses were used to examine patterns of implementation activities and strategies employed across the three phases of implementation.
One hundred and six discreet implementation activities and strategies were identified as innovative and were classified into five categories: 1) state infrastructure building and commitment, 2) stakeholder relationship building and communications, 3) financing, 4) continuous quality management, and 5) service delivery practices and training. Implementation activities from different categories were employed at different phases of implementation.
Insights into effective strategies for implementing EBPs in mental health and other health sectors require qualitative and quantitative research that seeks to: a) empirically test the effects of tools and methods used to implement EBPs, and b) establish a stronger evidence-base from which to plan, implement and sustain such efforts. This paper offers a classification scheme and list of innovative implementation activities and strategies. The classification scheme offers potential value for future studies that seek to assess the effects of various implementation processes, and helps establish widely accepted standards and criteria that can be used to assess the value of innovative activities and strategies.

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Available from: Jennifer L. Magnabosco, Apr 04, 2014
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    • "Financing for innovative mental health services is a challenge for many states and providers because of standardization and billing procedures (Magnabosco 2006). Medical necessity criteria involve documenting diagnoses and functional deficits in clients. "
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    Administration and Policy in Mental Health and Mental Health Services Research 07/2015; DOI:10.1007/s10488-015-0675-4 · 3.44 Impact Factor
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    • "The adoption, implementation, and sustainment of evidenced-based practices (EBPs) are becoming increasingly important for health and allied healthcare organizations and providers, and widespread adoption of EBPs holds promise to improve quality of care and patient outcomes [1,2]. Considerable resources are being allocated to increase the implementation of EBPs in community care settings with support for activities such as training service providers and increased staffing to support monitoring of implementation-related activities [3]. Although there are calls for increased attention to organizational context in EBP dissemination and implementation [4,5], there are gaps in examining how organizational context affects EBP implementation. "
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    Implementation Science 04/2014; 9(1):45. DOI:10.1186/1748-5908-9-45 · 3.47 Impact Factor
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    • "The characteristics of the EBPPs themselves present another challenge to the selection of implementation strategies [32,38,39]. Different types of EBPPs often require unique implementation strategies to ensure their implementation and sustainment [40,41]. "
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