Pennsylvania I believe
HI – where did they do this? Hudson River Region or in only some part of it?
NYAPRS Note: The article below offers a good example of how managed care organizations can be positive forces for recovery-focused collaborations and peer integration.
Implementing a Recovery-Oriented Learning Collaborative
Mental Health Weekly; James Gavin, MSW, April 2015
Four years ago in this space, I introduced Community Care Behavioral Health Organization’s newly formed Recovery Learning Collaborative, a network of 49 provider agencies that committed to change and transform services toward recovery-oriented practices (see MHW, Feb. 28, 2011). This was a relatively new concept in Behavioral health, and we weren’t certain how it would work.
Today, I’m happy to report that our Learning Collaborative model was a success. Providers are working together successfully and implementing practice changes that support recovery. Individuals are empowered to be part of the process and are reaping the benefits. And Community Care played a central role in stimulating innovation and positive changes in organizational culture.
In health care, Learning Collaboratives enhance quality of care by disseminating evidence-based practices in a variety of settings simultaneously. Using the “plan, do, study, act” approach, they leverage the power of the group to make systemwide changes that
benefit large numbers of patients. Typically, they are time-limited and have a singular focus (e.g., lowering patients’ cholesterol scores).
So how did a group of mental health providers — challenged to compete in the new health care environment — remain together for three years, making organizationwide changes to embed recovery in their language, attitudes and everyday operations? Both anecdotal evidence and a review of key data provide some critical answers.
We regularly introduced new practices and tools. The new practices were drawn from the CommonGround program, a Web-based application developed by Pat Deegan and Associates (PDA) that facilitates shared decision-making between providers and consumers. PDA designed two toolkits based on CommonGround: Personal Medicine, which helps individuals create wellness in their lives apart from the
use of prescribed medicine (introduced the first year); and Power Statements, which helps service users set goals for personal recovery and communicate those goals to their physicians (introduced the second year).
In the third year, a new toolkit, Whole Health Recovery Booster Pac, was presented to help people with psychiatric disabilities address physical health concerns. More than three-quarters of the participating agencies continue to use the toolkits after the formal conclusion
of the project.
We involved peers at every stage of the process. Peers became co-leaders on the agency teams that implemented the change to recovery-oriented practice. We established decision support centers in outpatient clinics and peer centers where peer staff helped individuals with serious mental illnesses use the CommonGround tools to prepare for each appointment with their psychiatrist. Over time, service users began using their Power Statements and Personal Medicine routinely. For its groundbreaking work in supporting shared decision-making, Community Care won an American Psychiatric Association Gold Achievement Award in 2013.
We developed, trained and supported Recovery Champions. To build internal capacity to sustain the innovation, Community Care staff members were selected to be facilitators based on their interest and reputation as Recovery Champions. Supervisors freed these staff for five to nine hours per month to provide leadership to specific regional groups within the Collaborative. Each facilitator received extensive
training from PDA faculty. Providers looked to the facilitators to help resolve implementation issues, foster the exchange of tools, and provide an ongoing structure for sharing successes and challenges — roles that were highly valued by the agencies.
We built and sustained the supporting infrastructure. To support the Learning Collaborative networks, we offered teleconferences; face-to-face meetings; daylong, team-building Recovery Institutes; multimedia toolkits; a newsletter; webinars; and rapid e-learning videos that even busy staff found time to watch. We provided robust support from quality improvement teams that included staff from each
agency, PDA and Community Care.
Regional Learning Collaborative facilitator Melissa Rufo, a recovery training coordinator at Community Care, highlights the evolution of the effort. She notes, “In the beginning, it was difficult to get the providers to share information with one another; it seemed like more
of a competition than collaboration. But over time, that sense of competition started to dissolve. [Providers] were able to make connections and help the individuals they serve in more meaningful ways. In a county where individuals often use services from more than one
[mental health] agency, this has been so important to turn the focus toward the individual and recovery.”
The Learning Collaborative initiative exceeded Community Care’s high expectations. It demonstrated that a managed care company can be a catalyst for change when committed staff, providers and peers work together to promote recovery.
James Gavin, MSW, is president and CEO of Community Care Behavioral Health Organization, part of the UPMC Insurance Services Division. Headquartered in Pittsburgh, Pennsylvania, Community Care is a nonprofit, provider-based, behavioral health managed care organization.