Service Lines and Other Organizational Arrangements at the Medical Center Level: A Preliminary Review

Charns, Martin P.; Wubbenhorst, William H.; Fonseca, Maria de Jesus Mendes da; Pucci, Linda

doi:10.1037/e583302006-001

Cited by 1 publication

(3 citation statements)

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“…Seventy-one medical centers reported the senior psychologist either was a Service Line Director or reported to a Service Line Director. This finding is consistent with the report of Charns et al (1999) that some form of interdisciplinary organization is the norm in VHA mental health programs. That report indicates that interdisciplinary organizational arrangements (IOAs), (a) have existed in VHA since at least 1993, (b) started becoming more common in mental health and primary care areas in 1996, and (c) existed for mental health at 108 medical centers by 1998.…”

Section: Survey Of Vha Senior Psychologistssupporting

confidence: 93%

“…Further, senior psychologists reported that psychologists were not formally considered for almost half (46%) of the top mental health leadership position vacancies during Fiscal Years (FY) 1998 and 1999. Charns et al (1999) reported that 70% of mental health IOA managers are psychiatrists and 15% are psychologists, which is consistent with our finding that a psychiatrist is more likely to be the top mental health manager than is a psychologist.…”

Section: Administrative Structuresupporting

confidence: 91%

“…In real dollars, the budget decreased, necessitating reductions in the number of VHA employees, while the number of veterans enrolled in VHA increased. At many facilities, long-standing discipline-specific organizational entities were replaced by multidisciplinary “service lines” or “care centers” (Charns, Wubbenhorst, Fonseca, Pucci, & Parker, 1999). For example, many independent Psychology and Psychiatry Services, along with personnel from Nursing and Social Work Services, were combined into a Mental Health Service Line.…”

mentioning

confidence: 99%

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The impact of the Veterans Health Administration (VHA) reorganization on psychology programs: A survey of VHA psychology leaders.

Cannon

Kivlahan

Gresen³

et al. 2001

Professional Psychology: Research and Practice

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Because the Veterans Health Administration (VHA) is the nation's largest health care system and employer and trainer of psychologists, changes in VHA psychology have implications for the rest of the profession. A national survey of 127 VHA psychology leaders (91% response rate) documented that many psychologists now are managed by a psychiatrist, deliver more outpatient services, and do less personality testing. In the context of a 10% reduction in psychology staffing, morale is rated lower than 2 years earlier. Diversified professional roles are associated with higher status of psychology and management support for mental health programs. Psychologists need to understand and respond adaptively to the organizational and economic forces affecting their practice.Motivated by a commitment to making quality health care more patient-centered and cost-efficient (Kizer, Fonseca, & Long, 1997), the Veterans Health Administration (VHA) of the U.S. Department of Veterans Affairs has been undergoing a major reorganization since 1995 that has had major impacts on VHA psychologists and VHA psychology training programs. This report summarizes the results of a national survey of VHA psychology leaders that was conducted in 1999 to assess the effects of this reorganization on VHA psychology. Specifically, the survey asked about changes in the administrative structure within which psychological services are delivered, staffing levels, practice patterns, administrative and training effort, the morale of psychologists, the status of the profession of psychology, and management support for mental health programs.The size and historical importance of the psychology program in VHA make changes in VHA psychology significant for psychol-DALE S. CANNON received his PhD in clinical psychology from the University of Utah in 1970. He is chief, Informatics Section, Mental Health Strategic Health Care Group, Veterans Affairs (VA) Headquarters.