Jim Myers, MSW

As your project continues its effort to move the needle up the integrated behavioral health (IBH) continuum towards full integration, tackling such issues as no-show rates, electronic health record systems, and screening rates, it is important to periodically check-in on the effectiveness of your IBH team. The authors of this article argue,

In integrated care, it is less about each team member playing a specific role and more about the interconnectedness of the interventions… [This is important because] The effectiveness of the team and the degree of collaboration and synergy between team members may actually be what makes the treatment successful (p. 7).

In the article produced by the SAMHSA-HRSA Center for Integrated Health Solutions, the authors identified four (4) elements of focus for effective IBH teams: 1) leadership and organizational commitment; 2) team development; 3) team process; and 4) team outcomes. Though the focus of the article is primarily on implementation of IBH, the elements identified in the article have practical application for established IBH programs, providing an approach to periodically check-in on team effectiveness (e.g., when a change in leadership occurs or hiring new IBH staff).

An overview of each of the four (4) elements is provided below:

  1. Leadership and Organizational Commitment: For an IBH team to be effective, there needs to be an important level of “buy-in” from the leadership and the organization. The authors suggest that when leadership fails to commit to IBH, “the model does not fully form or is not sustained” (p. 8). To be an effective IBH program, leadership and organization need to be committed to the philosophy of integrated care (e.g., allowing the IBH team to spend substantial amounts of non-billable hours on integration efforts), which includes being motivated to delivering “the right care” for its clients and taking some risks, such as expecting that time and resources will eventually yield the desired outcomes.
  2. Team Development: The authors argue that team development is often “overlooked or minimized.” In IBH, it is important to understand the roles and responsibilities within a team so that IBH team members can adapt their practice style and/or adapt their competencies to treat the whole person (i.e., patient). In team development, having a shared vision between leadership/organization and the IBH team is key as it provides structure and clarity to implementing and refining IBH efforts. Additionally, shared team values are key to team development because the values can bind the team together as a group, reduce conflict, and provide “clarity of action in patient care” (p. 12). The authors suggest that shared personal attributes among staff are important in supporting a team-based approach, as well as possessing the Institute of Medicine’s (IOM) five (5) personal values of effective team members in health care: honesty, discipline, creativity, humility, and curiosity.
  3. Team Process: Another key to IBH is continued assessment of team functioning and dynamics by providing timely feedback of the team’s progress toward goals. “Effective teams ask themselves, ‘Is this team process working the way it is designed, and at its best for patient care?’” (p. 18).
  4. Team Outcomes: Identifying clear, predetermined outcomes that are tracked and monitored through objective measures are significant tenants of team outcomes. Predetermined outcomes, the authors report, reduce conflict regarding treatment approach and create clarity in treatment goals, while guiding patient care. Additionally, the authors suggest that having agreed upon team outcomes is associated with team members feeling comfortable when discussing IBH approaches that are not working and to creating alternative approaches. One (1) suggested approach to tracking team outcomes is to, “collect data on patient satisfaction and work closely with patients to gain regular feedback on experience…and additional needs” (p. 22).

If this article piqued your interest in tracking the essential elements of effective IBH teams, it is strongly suggested that you read the entire article, as it provides useful information (including case studies) to support your efforts in assessing the effectiveness of your IBH team.

References

SAMHSA-HRSA Center for Integrated Health Solutions (2014). Essential Elements of Effective Integrated Primary Care and Behavioral Health Teams. https://ccf.georgetown.edu/wp-content/uploads/pdfs/Essential_Elements_of_an_Integrated_Team.pdf