Implementation Guide

Address Unanticipated Challenges

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Either during or soon after the launch of Collaborative Care, you'll run into something you never thought of. Unanticipated challenges are normal and will occur. Go back to the work you've already done -- vision statement, clinical flowchart, etc -- and then weave a solution into your plan. Here are some sample barriers and solutions we've come across.


Lack of appreciation of the core principles of Collaborative Care

  • Address common misconception that Collaborative Care is the same as co-located care (working in the same place)
  • Focus on goal of improved patient outcomes
  • Develop a system to identify and track the population targeted by Collaborative Care effort
  • Deliver evidence based approaches to behavioral health
  • Encourage whole team responsibility for quality and outcomes of behavioral health care

Vision is not aligned with resources

  • Leadership buy-in
  • Identify and support resource needs
    • Collaborative Care may require additional staff
    • Make sure new staffing is adequate based on expected patient caseload
    • Consider practical needs such as patient registry, private space to see patients, computers, phone
    • Screen for only behavioral health issues the organization has resources to address
  • Address funding concerns
    • Anticipate costs for both short-term start-up and long-term sustainability
    • Consider creative partnerships
    • Assess billing practices
  • Champion to advocate for BHPs and other resources
  • Identify referral resources and partners (e.g. for social needs)

Communication Challenges

  • Provide orientation to all team members
  • Promote clear vision of goals for program
  • Develop workflow with special attention to method and timing of team member communication

Limited time and resources to a build team

  • Identify facilitator/champion to lead this process
    • Leadership to advocate for time to complete assessment and participate in facilitated team building
  • Schedule adequate time for team building and give the work group a clear timeline
  • Consider using AIMS team building tool or other facilitated process to build team and develop work flow
  • It is never too late to build or re-build a team!

Inadequate skills in effective teamwork

  • Plan training and practice specific collaborative care skills (e.g. integrated care planning)
  • Train together
    • Ideally all team member participate in training as group
    • Each member should understand model of program and individual roles/responsibilities
  • Consider online programs for training
  • Review program effectiveness in regularly scheduled QI meetings after program launch and identify needs for additional training and resources.

Individual concerns about scope of practice

  • Seek to understand concerns of providers
  • Acknowledge strengths of team members and apply those skills to new role
  • Clearly define roles through team building within scope of practice for each provider
  • Provide training to support team in performing in new roles
  • Focus on patient outcomes and collaborative care tasks to reach those outcomes

Team Burnout

  • Address lack of resources in initial phase of project
  • Focus on good team communication
  • Publically share success stories
  • Regularly review workflow and revise as needed
  • Consider team reflection to address inevitable challenges