Planning Care in the Clinical, Operational, and Financial Worlds

Peek, C. J.

doi:10.1007/978-0-387-76894-6_3

Cited by 71 publications

(74 citation statements)

References 1 publication

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“…Based on Peek's 13 observation that care is multidimensional and is both a clinical and organizational activity, the research team constructed 2 indices from items contained in the survey (Online Appendix 1). We categorized items as related to the organization of care delivery or to clinical care.…”

Section: Mental Health Organization and Clinical Indexmentioning

confidence: 99%

Mental Health, Substance Abuse, and Health Behavior Services in Patient-Centered Medical Homes

Kessler¹,

Miller

Kelly³

et al. 2014

The Journal of the American Board of Family Medicine

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Purpose: The purpose of this study was to understand mental health, substance use, and health behavior activities within primary care practices recognized by the National Committee for Quality Assurance as patient-centered medical homes (PCMHs).Methods: We identified 447 practices with all levels of National Committee for Quality Assurance PCMH recognition as of March 1, 2010. We selected the largest practice from multisite groups, and 238 practices were contacted. We received 123 responses, for a 52% response rate. A 40-item web-based survey was collected.Results: Of PCMH practices, 42% have a behavioral health clinician on site; social workers were the most frequent category of provider delivering behavioral services. There are also were care managers-distinct from behavioral health clinician-at 62% of practices. Surveyed practices were less likely to have procedures for referrals, communication, and patient scheduling for responding to mental health and substance use services than for other medical subspecialties (50% compared with 73% for cardiology and 69% for endocrinology). More than half of practices (62%) reported using electronic, standardized depression screening and monitoring; practices were less likely to screen for substance use than mental health. Among the practices, 54% used evidence-based health behavior protocols for mental health and substance use conditions. Practices reported that lack of reimbursement, time, and sufficient knowledge were obstacles. Practices serving a higher proportion of low-income patients performed more mental health organizational and clinical activities.Conclusions: In PCMHs, practice organization and response to behavioral issues seem to be less well developed than other types of medical care. These results support further efforts to develop wholeperson care in the PCMH, with greater emphasis on access to and coordination of mental health, substance abuse, and health behavior services. Even though primary care is the setting for a large portion of care for behavioral health problems (defined here as care for mental health, substance use disorders, and health behaviors), these problems are often inadequately addressed in primary care.1-3 Little has been written about current behavioral health clinician capacity in primary care. It has been suggested that less than 10% of psychologists practicing work in primary care settings.

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Section: Mental Health Organization and Clinical Indexmentioning

confidence: 99%

Mental Health, Substance Abuse, and Health Behavior Services in Patient-Centered Medical Homes

Kessler¹,

Miller

Kelly³

et al. 2014

The Journal of the American Board of Family Medicine

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“…Aligning with Peek's (2008) three worlds of healthcare, we must evaluate MedFT across clinical, operational, and financial arenas. We can employ qualitative methods to tap patients', families', providers', and/or administrators' experiences with different care types and clinical procedures.…”

Section: Summary and Discussionmentioning

confidence: 99%

“…These include: (a) the clinical world that endeavors to provide exceptional patient care; (b) the operational world that works to employ efficient, well-integrated, and patient-friendly systems; and (c) the financial world that acts to stay economically viable through cost-effective utilization of healthcare resources (Patterson et al 2002;Peek 2008).…”

Section: A Lexicon For Disseminationmentioning

confidence: 99%

Advancing Medical Family Therapy Through Research: A Consideration of Qualitative, Quantitative, and Mixed-Methods Designs

et al. 2012

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To survive in today's healthcare climate, stakeholders across all mental health disciplines must work to produce empirical evidence that earns their fields' regard by educators, providers, and policy makers. As the field of Medical Family Therapy (MedFT) answers this call, it will be important for researchers to clearly define, characterize, and assess MedFT practice across clinical, operational, and financial arenas of care. In this account, we propose a common lexicon from which to do this, highlighting the following core tenets of MedFT: systems theory, biopsychosocial-spiritual sensitivity in practice, agency, communion, interdisciplinary collaboration, and the three-world model of healthcare. We conclude by offering concrete ways to advance the MedFT research agenda using qualitative, quantitative, and mixed-method approaches.Keywords Collaborative family healthcare Á Integrated healthcare Á Medical Family Therapy Á Research agenda Á Research methods Over the past two decades, Medical Family Therapy (MedFT) has emerged as a distinctive subspecialty of Marriage and Family Therapy. Since its foundation, MedFT has adapted and evolved in response to the dynamic and ever-changing landscapes of healthcare, including the advent of healthcare maintenance organizations, the Patient Protection and Affordable Care Act, and recent calls for patient-centered medical homes. These shifts in care contexts have presented both challenges and opportunities for the development of innovative disciplines with practitioners who specialize in collaborative care. To survive in today's healthcare climate, all mental health disciplines must work harder to produce empirical evidence that contributes to the body of knowledge about the respective and overlapping effectiveness of treatment approaches to earn favor by educators, providers, and policy makers. As we work to answer this call, researchers must clearly define, characterize, and assess MedFT across clinical, operational, and financial arenas of practice. To this end, the two-fold purpose of this paper is: (1) to establish/confirm a lexicon for MedFT research, and (2) to identify research methods (qualitative, quantitative, and mixedmethods) that bear promise to advance the field of MedFT.

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“…The 'Three World View' framework (Peek 2008;Peek andHeinrich 1995, 1998) offers a structure for reviewing each barrier and identifying where changes are needed. Using this framework, each healthcare system is seen as having three branches (e.g., worlds).…”

Section: Barriers and Strategies To Integrationmentioning

confidence: 99%

Integration: Opportunities and Challenges for Family Therapists in Primary Care

2012

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Integration of behavioral and physical health is becoming critical for the overburdened primary care system. Policy changes are needed to accommodate integration nationally. Locally, medical and behavioral health providers are working together to create models that better fit their patients' comprehensive needs while respecting the clinical, operational, and financial constraints of the current system. Family therapists trained to work in medical settings have an opportunity to emerge as clinical, research, and administrative leaders in this context. However, a paradigm shift is crucial to adapting their systemic orientation to interactions between individual patients, providers, staff, and healthcare and support systems. This article provides family therapists with: (1) an overview of the basic structure and barriers of integration, (2) suggestions on how to deliver quality care despite barriers at the local level, and (3) examples of key advocacy efforts representing possible entryways on a larger scale.

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Planning Care in the Clinical, Operational, and Financial Worlds

Abstract: Using multivariate statistics (6th ed.). Upper Saddle River, NJ: Pearson.

Cited by 71 publications

References 1 publication

Mental Health, Substance Abuse, and Health Behavior Services in Patient-Centered Medical Homes

Mental Health, Substance Abuse, and Health Behavior Services in Patient-Centered Medical Homes

Advancing Medical Family Therapy Through Research: A Consideration of Qualitative, Quantitative, and Mixed-Methods Designs

Integration: Opportunities and Challenges for Family Therapists in Primary Care

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