Observational studyJournal of the American Board of Family Medicine : JABFM
Clinician Staffing, Scheduling, and Engagement Strategies Among Primary Care Practices Delivering Integrated Care.
Observational study in Journal of the American Board of Family Medicine : JABFM. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Warm Handoffs for Improving Client Receipt of Services: A Systematic Review.Maternal and child health journal · 2021Pooled it
- Understanding Tinnitus Clinical Care in the Veterans Health Administration and Department of Defense: Overview of Survey Results.American journal of audiology · 2024Article
- A Pragmatic Approach to Identifying and Profiling Primary Care Clinicians and Primary Care Practices in the USA.Journal of general internal medicine · 2024Article
- Addressing Unmet Social Needs and Social Risks - A Qualitative Interview-Based Assessment of Parent Reported Outcomes and Impact from a Medical Legal Partnership.The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics · 2024Article
- Healthcare workers' perceptions and experiences of primary healthcare integration: a scoping review of qualitative evidence.The Cochrane database of systematic reviews · 2023Article
- Healthcare workers' perceptions and experiences of primary healthcare integration: a scoping review of qualitative evidence.The Cochrane database of systematic reviews · 2023Article
- Measuring Behavioral Health Integration in Primary Care.Population health management · 2022Article
- Improving functioning in HIV+ patients with chronic pain and comorbid depression: Protocol for a randomized clinical trial testing a collaborative behavioral health intervention based on behavioral activation.Contemporary clinical trials · 2022Article
- A Missed Opportunity? How Health Care Organizations Engage Primary Care Clinicians in Formal Social Care Efforts.Population health management · 2022Article
- Patient Views of Behavioral Health Providers in Primary Care: A Qualitative Study of 2 Southeastern Clinics.Journal of patient experience · 2020Article
- Translating Research into Agile Development (TRIAD): Development of Electronic Health Record Tools for Primary Care Settings.Methods of information in medicine · 2019Article
- Warm Handoffs and Attendance at Initial Integrated Behavioral Health Appointments.Annals of family medicine · 2018Article
- The State and Future of the Primary Care Behavioral Health Model of Service Delivery Workforce.Journal of clinical psychology in medical settings · 2018Article
- A Practical Risk Stratification Approach for Implementing a Primary Care Chronic Disease Management Program in an Underserved Community.Journal of health care for the poor and underserved · 2018Article
- A Practical Framework for Understanding and Reducing Medical Overuse: Conceptualizing Overuse Through the Patient-Clinician Interaction.Journal of hospital medicine · 2017Review
- Predisposing Characteristics, Enabling Factors, and Need as Predictors of Integrated Behavioral Health Utilization.The journal of behavioral health services & research · 2017Article
- Implementation of behavioral health interventions in real world scenarios: Managing complex change.Families, systems & health : the journal of collaborative family healthcare · 2017Observational
- Integration of behavioral health and primary care: current knowledge and future directions.Journal of behavioral medicine · 2017Review
- Payment reform in the patient-centered medical home: Enabling and sustaining integrated behavioral health care.The American psychologist · 2017Article
- Evaluation of an Electronic Health Record (EHR) Tool for Integrated Behavioral Health in Primary Care.Journal of the American Board of Family Medicine : JABFMArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
purposeTo examine the interrelationship among behavioral health clinician (BHC) staffing, scheduling, and a primary care practice's approach to delivering integrated care.
methodsObservational cross-case comparative analysis of 17 primary care practices in the United States focused on implementation of integrated care. Practices varied in size, ownership, geographic location, and integrated care experience. A multidisciplinary team analyzed documents, practice surveys, field notes from observation visits, implementation diaries, and semistructured interviews using a grounded theory approach.
resultsAcross the 17 practices, staffing ratios ranged from 1 BHC covering 0.3 to 36.5 primary care clinicians (PCCs). BHC scheduling varied from 50-minute prescheduled appointments to open, flexible schedules slotted in 15-minute increments. However, staffing and scheduling patterns generally clustered in 2 ways and enabled BHCs to be engaged by referral or warm handoff. Five practices predominantly used warm handoffs to engage BHCs and had higher BHC-to-PCC staffing ratios; multiple BHCs on staff; and shorter, more flexible BHC appointment schedules. Staffing and scheduling structures that enabled warm handoffs supported BHC engagement with patients concurrent with the identification of behavioral health needs. Twelve practices primarily used referrals to engage BHCs and had lower BHC-to-PCC staffing ratios and BHC schedules prefilled with visits. This enabled some BHCs to bill for services, but also made them less accessible to PCCs in when patients presented with behavioral health needs during a clinical encounter. Three of these practices were experimenting with open scheduling and briefer BHC visits to enable real-time access while managing resources.
conclusionPractices' approaches to PCC-BHC staffing, scheduling, and delivery of integrated care mutually influenced each other and were shaped by the local context. Practice leaders, educators, clinicians, funders, researchers, and policy makers must consider these factors as they seek to optimize integrated systems of care.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.