Workflow Resources

It's important to know how your team will function the moment a patient walks through the door, including protocols for suicidal patients and patients in crisis. Planning and creating a clinical flow that shows the exact process of what happens when a patient comes to the clinic ensures that no patient falls through the cracks. Mapping a patient's care experience — from identifying a behavioral health care need to initiating treatment to communicating treatment adjustments — provides a framework for knowing the next step of care.

Workflow Development

• Leadership completes the pre-launch readiness tool; the practice coach should provide guidance as needed. Leadership is informed of the other components of the workflow (screening and treatment workflows, see below), and that a regular check-in and modifications to the plan should be made to work on improvements on an ongoing basis. This should be included in a standing meeting and feedback loops to each department should be developed.
• Pre-Launch Readiness Tool
• Depression Screening and Case-Finding Toolkit
• Screening Workflow Planning Tool
• Treatment Workflow Planning Tool
• Sample Workflow
• Sample PHQ-9 Workflow

Screening Resources

Screen for Childhood Anxiety Related Emotional Disorders (SCARED)

• California Evidence-Based Clearinghouse for Child Welfare: general information about screener
• University of Pittsburgh: public copies of screener for download
• Article: Screen for Child Anxiety-Related Emotional Disorders (SCARED): convergent and divergent validity. (2000)
• GAD-7 screener is also commonly used with client populations ages 12 and up

Drug and Alcohol Use Screeners

• American Society of Addiction Medicine
• National Institute on Drug Abuse: Chart of tools with factors to consider
• SAMHSA-HRSA: screening tools

Sample Workflow Timeline: 2 to 4 weeks 

• The practice coach orients the clinical team (or care manager) to the workflow planning process and workflow tools (if clinical team - screening workflow tool; if care manager and behavioral health manager: screening workflow and treatment workflow tools).
• The clinical team (the care manager and ideally a representative from each role: PCP champion, MA or other nursing staff, front office) complete the screening workflow tool together and shares it with the practice coach for feedback before in-person training.
• The care manager completes the treatment workflow tool with the support of their supervisor; the practice coach should provide guidance as needed. The completed workflow (screening and treatment) is submitted to the practice coach for feedback.

Workflow Timeline: In-person training

• If attending an in-person training (trainings are scheduled based on need and trainer availability), care managers bring a copy of their full clinic workflows (combined all parts above) to the training. Opportunities to begin revising workflows will be provided at key points during the day (on their own). However, the workflows will not be reviewed by trainers during the training. This should be completed beforehand.

Workflow Timeline: post-launch training

• Practice coach works with care manager to discuss PDSA/QI spirit of checking in on how each component of the workflow is going on a continual basis, and developing a process for making changes. Meetings and feedback loops with leadership will be discussed. Key message: modifications to the original plan are typically always needed after a trial period and we have feedback on the process and from the individuals involved.
• Training team works with care manager, program lead, and key leadership to develop an Organizational Relapse Prevention Plan in order to maintain the collaborative care workflow and prevent a relapse to care as usual
• Organizational Relapse Prevention Plan Action Planning Sheet
• Organizational Relapse Prevention Plan slide handout