Implementing Key Strategies for Successful Network Integration in the Quebec Substance-Use Disorders Programme

Fleury, Marie‐Josée; Perreault, Michel; Grenier, Guy; Imboua, Armelle; Brochu, Serge

doi:10.5334/ijic.2457

Cited by 21 publications

(17 citation statements)

References 70 publications

(93 reference statements)

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“…There was also a high degree of covariance with network integration strategies in the study: standardized procedures, evaluation tools and clinical approaches are in fact included in the notion of network integration, and their use is known to produce better outcomes [52]. …”

Section: Discussionmentioning

confidence: 99%

Relations between mental health team characteristics and work role performance

et al. 2017

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Effective mental health care requires a high performing, interprofessional team. Among 79 mental health teams in Quebec (Canada), this exploratory study aims to 1) determine the association between work role performance and a wide range of variables related to team effectiveness according to the literature, and to 2) using structural equation modelling, assess the covariance between each of these variables as well as the correlation with other exogenous variables. Work role performance was measured with an adapted version of a work role questionnaire. Various independent variables including team manager characteristics, user characteristics, team profiles, clinical activities, organizational culture, network integration strategies and frequency/satisfaction of interactions with other teams or services were analyzed under the structural equation model. The later provided a good fit with the data. Frequent use of standardized procedures and evaluation tools (e.g. screening and assessment tools for mental health disorders) and team manager seniority exerted the most direct effect on work role performance. While network integration strategies had little effect on work role performance, there was a high covariance between this variable and those directly affecting work role performance among mental health teams. The results suggest that the mental healthcare system should apply standardized procedures and evaluation tools and, to a lesser extent, clinical approaches to improve work role performance in mental health teams. Overall, a more systematic implementation of network integration strategies may contribute to improved work role performance in mental health care.

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Section: Discussionmentioning

confidence: 99%

Relations between mental health team characteristics and work role performance

et al. 2017

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“…Primary care teams often used motivational interviewing, which should be particularly effective for co-occurring MHD-SUD [ 56 ]. This may reflect the training offered to HSSC primary care teams by the Quebec Ministry from 2007, as part of its SUD program [ 57 ], that was generated by the high prevalence of co-occurring disorders in MH caseloads. Research suggests that half of individuals with a lifetime SUD may also have at least one lifetime MHD [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

“…In terms of liaison officers, participants cited their interactions with addiction specialist nurses as most satisfactory. The added value of liaison officers was underscored by the implementation of liaison teams to reduce the overflow of individuals with SUDs in emergency rooms in the context of the ministerial reform of the SUD program that was occurring simultaneously [ 57 ]. Working in partnership with emergency rooms and hospital units, the liaison teams systematically tracked clients with SUD or co-occurring MH-SUD and directed them to appropriate services [ 60 ].…”

Section: Discussionmentioning

confidence: 99%

Implementation of the Quebec mental health reform (2005–2015)

Fleury

Grenier

Vallée

et al. 2016

BMC Health Serv Res

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BackgroundThis study evaluates implementation of the Quebec Mental Health (MH) Reform (2005–2015) which aimed to improve accessibility, quality and continuity of care by developing primary care and optimizing integrated service networks. Implementation of MH primary care teams, clinical strategies for consolidating primary care, integration strategies to improve collaboration between primary care and specialized services, and facilitators and barriers related to these measures were examined.MethodsEleven Quebec MH service networks provided the study setting. Networks were identified in consultation with 20 key MH decision makers and selected based on variation in services offered, integration strategies, best practices, and geographic criteria. Data collection included: primary documents, structured questionnaires completed by 25 managers from MH primary care teams and 16 respondent-psychiatrists working in shared-care, and semi-structured interviews with 102 network stakeholders involved in the reform. The study employed a mixed method approach, triangulating the three data sources across networks.ResultsWhile implementation was not fully achieved in most networks, the Quebec reform succeeded in improving primary care services with the creation of adult primary care teams, and one-stop services which increased access to care, mainly for clients with common MH disorders. In terms of clinical strategies implemented, the functions provided by respondent-psychiatrists had a greater impact on the MH primary care teams than on general practitioners (GPs) in medical clinics; whereas the implementation of best practices were indirect outcomes of another reform developed simultaneously by the Quebec substance use disorders program. The main integration strategies used for increasing continuity of care and collaboration between primary care and specialized services were those involving fewer formal procedures such as referrals between teams and organizations. The lack of operational mechanisms and protocols governing new services and structures were important barriers to primary care consolidation and service integration, as was the lack of interest and involvement of most GPs in MH.ConclusionsSuccessful and sustained healthcare reform requires attention to process and outcomes as well as structural change or service reorganization. Six recommendations for more successful implementation of the Quebec MH Reform are provided, with implications for healthcare reform internationally.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1832-5) contains supplementary material, which is available to authorized users.

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“…An estimated 4.4% of Canadians aged 15 and older have a substance-use disorder, with alcohol dependence most prevalent at 3.2% (19). As integrated care is complex and little is known about what it entails for youth, designing, and implementing programs for youth lends further complexity.…”

Section: Resultsmentioning

confidence: 99%

Models of Concurrent Disorder Service: Policy, Coordination, and Access to Care

et al. 2019

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Background: Societal capacity to address the service needs of persons with concurrent mental health and substance-use disorders has historically been challenging given a traditionally siloed approach to mental health and substance-use care. As different approaches to care for persons with concurrent disorders emerge, a limited understanding of current models prevails. The goal of this paper is to explore these challenges along with promising models of coordinated care across Canadian provinces. Materials and methods: A scoping review of policies, service coordination and access issues was undertaken involving a review of the formal and gray literature from 2000 to 2018. The scoping review was triangulated by an analysis of provincial auditor general reports. Results: Models of concurrent disorders service were found to have evolved unevenly. Challenges related to the implementation of models of collaborative care and local networks that foster service coordination and policy accountability were found to inhibit integrated care. Conclusion: Emergent models of coordinated care were found to include collaborative care, regional networks with centralized access to care, clinical information-sharing, cross-training, improved scope of care to include psychologists and alignment of physician incentives with patient needs to better support patient care.

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Implementing Key Strategies for Successful Network Integration in the Quebec Substance-Use Disorders Programme

Cited by 21 publications

References 70 publications

Relations between mental health team characteristics and work role performance

Relations between mental health team characteristics and work role performance

Implementation of the Quebec mental health reform (2005–2015)

Models of Concurrent Disorder Service: Policy, Coordination, and Access to Care

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