Jennifer Donahue
Communications Manager, WCAAP
Improving behavioral health care and access is one of the clinical goals of Washington’s Pediatric Transforming Clinical Practice Initiative (P-TCPI). P-TCPI works with primary care and behavioral health providers to integrate care by establishing reliable communication between silos, improving referral pathways, and educating primary care providers on managing behavioral health needs and psychotropic medications within their practice. P-TCPI has created the Behavioral Health Toolkit to help primary care and behavioral health providers form such partnerships between primary care and behavioral health providers
The foundation of this work lies in asking three important questions and working through the process of answering those questions:
ACCESS: What can I do in my own scope of practice? When should I refer out and how can I get my patient in the door to receive specialty behavioral health care?
ONGOING COMMUNICATION: How do I know that the referral “stuck” – that my patient and family followed through and received care?
INFORMATION SHARING: How do I know what happened? How can I learn status, progress, and/or outcome of behavioral health interventions before the patient comes back to my office?
In Spokane, MultiCare Rockwood Clinic and Frontier Behavioral Health are forging a successful partnership with the help of their regional P-TCPI team, including physician champion Dr. Sam Keblawi (Rockwood), behavioral health champion Chris Coppen (Frontier), and Reese Holford (DOH Practice Facilitator). The goals include getting confirmation from the behavioral health provider (BH) to the primary care provider (PCP) when intake occurs, indicating diagnosis. The BH later confirms with the PCP when a counseling appointment occurs and shares the treatment plan, including updates to the PCP on medications if prescribed.
Throughout the process, both parties continue to learn some important lessons, including that even something as simple as creating a form can take an investment of time. Regular meetings are critical to keeping the process on track, as it helps develop relationships and improve communication. “A side-benefit of this collaboration has been that Frontier Behavioral Health intends to modify the forms to be used with other agencies,” says Coppen. “So this has become kind of a prototype to be used more broadly.”
Other takeaways:
- The process takes time; be patient.
- Begin with an understanding that both entities share the same passion.
- Don’t let divergent vocabulary get in the way!
- The lack of relationships is an obstacle – overcome it by investing in face time.
- Sharing information is foundational.
- Forms aren’t glamorous, but are a great place to start.
- Be explicit about assigning responsibility.
- Continuously assess, monitor and problem solve as barriers arise.
- Steal shamelessly!
- Use the P-TCPI Behavioral Health Toolkit and its sample forms to establish relationships to share care in your community.