ArticleJournal of general internal medicine2014
The anatomy of primary care and mental health clinician communication: a quality improvement case study.
Article in Journal of general internal medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Japanese family physicians' attitudes, difficulties, and perceived significance in managing mental health problems: A qualitative study.Journal of general and family medicine · 2025Article
- Patient experiences with a primary care medical home tailored for people with serious mental illness.Families, systems & health : the journal of collaborative family healthcare · 2024Article
- Empowering primary care physicians in child and adolescent psychiatry: a needs assessment on collaborative care in Dubai.Frontiers in medicine · 2024Article
- Random or predictable?: Adoption patterns of chronic care management practices in physician organizations.Implementation science : IS · 2017Article
- Perspectives of Migrant Youth, Parents and Clinicians on Community-Based Mental Health Services: Negotiating Safe Pathways.Journal of child and family studies · 2017Article
- Sharing a Playbook: Integrated Care in Community Health Centers in the United States.American journal of public health · 2015Article
- Transitioning patients from outpatient mental health services to primary care: A rapid literature review.Implementation research and practiceReview
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe high prevalence of comorbid physical and mental illnesses among veterans is well known. Therefore, ensuring effective communication between primary care (PC) and mental health (MH) clinicians in the Veterans Affairs (VA) health care system is essential. The VA's Patient Aligned Care Teams (PACT) initiative has further raised awareness of the need for communication between PC and MH. Improving such communication, however, has proven challenging.
objectiveTo qualitatively understand barriers to PC-MH communication in an academic community-based clinic by using continuous quality improvement (CQI) tools and then initiate a change strategy. DESIGN, PARTICIPANTS, AND APPROACH: An interdisciplinary quality improvement (QI) work group composed of 11 on-site PC and MH providers, administrators, and researchers identified communication barriers and facilitators using fishbone diagrams and process flow maps. The work group then verified and provided context for the diagram and flow maps through medical record review (32 patients who received both PC and MH care), interviews (6 stakeholders), and reports from four previously completed focus groups. Based on these findings and a previous systematic review of interventions to improve interspecialty communication, the team initiated plans for improvement. KEY
resultsKey communication barriers included lack of effective standardized communication processes, practice style differences, and inadequate PC training in MH. Clinicians often accessed advice or formal consultation based on pre-existing across-discipline personal relationships. The work group identified collocated collaborative care, joint care planning, and joint case conferences as feasible, evidence-based interventions for improving communication.
conclusionsCQI tools enabled providers to systematically assess local communication barriers and facilitators and engaged stakeholders in developing possible solutions. A locally tailored CQI process focusing on communication helped initiate change strategies and ongoing improvement efforts.
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