Behavioral Health Interdisciplinary Program - Collaborative Chronic Care Model (BHIP-CCM) Enhancement Project 2.0

VA Office of Research and Development

Status: Active, not recruiting

Conditions: Mental Health

Treatments: Other: Implementation Facilitation; Other: Centralized Technical Assistance

Study type: Interventional

Funder types: Other U.S. Federal agency; Other

Identifiers

NCT05997836

QUX 23-002

Details and patient eligibility

About

This quality improvement project aims to help outpatient mental health teams, known as Behavioral Health Interdisciplinary Program (BHIP) teams, adopt more collaborative care practices (consistent with the collaborative chronic care model or CCM). The investigators therefore aim to use two different implementation strategies -- centralized technical assistance and implementation facilitation -- to align BHIP teams' care practices more closely with the principles of the CCM.

Full description

This quality improvement project aims to help outpatient mental health teams, known as Behavioral Health Interdisciplinary Program (BHIP) teams, adopt more collaborative care practices (consistent with the collaborative chronic care model or CCM). The investigators therefore aim to use two different implementation strategies -- centralized technical assistance and implementation facilitation -- to align BHIP teams' care practices more closely with the principles of the CCM.

The two primary outcomes of this project are:

1. BHIP team collaboration, as evidenced by improved scores in the Role Clarity and Team Primacy dimensions of the Team Development Measure (TDM)
2. BHIP team clinical effectiveness, as evidenced by reduction in mental health hospitalizations among Veterans treated by the BHIP teams that have received the two types of implementation strategies described above.

Enrollment: 81,424 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Note that treatment assignment will be at the facility level, and given the stepped wedge design, sites in Waves 2-4 will cross over from Centralized Technical Assistance to Implementation Facilitation.
• At the provider level (for completing the TDM), the primary inclusion criterion is clinicians working on BHIP Teams at the participating medical centers.
• At the patient level (for mental health hospitalizations, costs, and all-cause mortality), the primary inclusion criterion is Veterans treated by the BHIP teams at the participating medical centers.
• Note that, for mental health hospitalizations, separate sites have been identified as comparators using a balancing algorithm.

Exclusion criteria

• Patients with a diagnosis of dementia in the electronic medical record.

Trial design

Primary purpose: Health Services Research

Allocation: Non-Randomized

Interventional model: Crossover Assignment

Masking: None (Open label)

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81,424 participants in 4 patient groups

Wave 1

Other group

Description:

Study design is a stepped wedge; Wave 1 begins by receiving Implementation Facilitation

Treatment:

Other: Implementation Facilitation

Wave 2

Other group

Description:

Study design is a stepped wedge; Wave 2 begins by receiving Centralized Technical Assistance before crossing over to Implementation Facilitation

Treatment:

Other: Centralized Technical Assistance

Other: Implementation Facilitation

Wave 3

Other group

Description:

Study design is a stepped wedge; Wave 3 begins by receiving Centralized Technical Assistance before crossing over to Implementation Facilitation

Treatment:

Other: Centralized Technical Assistance

Other: Implementation Facilitation

Wave 4

Other group

Description:

Study design is a stepped wedge; Wave 4 begins by receiving Centralized Technical Assistance before crossing over to Implementation Facilitation

Treatment:

Other: Centralized Technical Assistance

Other: Implementation Facilitation