“…Concerning culture, participants called for culture change ( 24 , 31 , 47 , 56 ) and mentioned the need for specific cultures, particularly cultures that are transparent and blame-free ( 14 , 31 , 48 , 53 , 56 , 66 , 69 , 72 ). Related to HR and capacity, studies discussed staffing constraints ( 33 , 49 , 59 , 61 ), the importance of staff stability ( 24 , 59 , 66 ), staff composition including the use of alternative providers and medical assistants [e.g., ( 14 , 24 , 33 , 35 , 60 , 64 – 66 , 71 , 72 , 76 )] and specific open job positions ( 33 , 34 , 62 , 72 , 78 ). Remarks made about organizational facilities and approaches involved professionals' desire for dedicated VBHC time ( 14 , 59 , 66 ), step-by-step implementation ( 34 , 35 , 56 , 72 , 76 ), and an overall supportive environment ( 24 , 31 , 53 , 54 , 56 , 57 , 59 , 62 , 65 , 66 , 72 , 73 ) with specific attention for engaged leadership ( 14 , 33 , 35 , …”