Literature Collection

This case study describes the process of implementing and evaluating an interprofessional collaborative practice (IPCP) program for primary care and behavioral health integration focused on chronic disease management. The result was a strong IPCP program in a nurse-led federally qualified health center serving medically underserved populations. The IPCP program at the Larry Combest Community Health and Wellness Center at the Texas Tech University Health Sciences Center spanned >10 years of planning, development, and implementation, supported by demonstration, grants, and cooperative grants from the Health Resources and Services Administration. The program launched 3 projects: a patient navigation program, an IPCP program for chronic disease management, and a program for primary care and behavioral health integration. We established 3 evaluation domains to track the outcomes of the program: TeamSTEPPS education outcomes (Team Strategies and Tools to Enhance Performance and Patient Safety), process/service measures, and patient clinical and behavioral measures. TeamSTEPPS outcomes were evaluated before and after training on a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree). Mean (SD) scores increased significantly in team structure (4.2 [0.9] vs 4.7 [0.5]; P < .001), situation monitoring (4.2 [0.8] vs 4.6 [0.5]; P = .002), and communication (4.1 [0.8] vs 4.5 [0.5]; P = .001). From 2014 to 2020, the rate of depression screening and follow-up improved from 16% to 91%, and the hypertension control rate improved from 50% to 62%. Lessons learned include recognizing partner contributions and the worth of each team member. Our program evolved with the help of networks, champions, and collaborative partners. Program outcomes show the positive impact of a team-based IPCP model on health outcomes among medically underserved populations.

In shared decision-making (SDM) with families facing complex problems, interprofessional decision-making is an essential part of providing appropriate care yet complicated by the differing perspectives and responsibilities of professionals involved. To strengthen interprofessional decision-making often multidisciplinary teams, such as Specialist Integrated care Teams (SITs), are organized. Since little is known on how interprofessional decision-making is practiced in this setting, this study explores facilitators and barriers of interprofessional decision-making within SITs and with other care services. We gathered perspectives of families, professionals, and organizational managers of SITs by 43 semi-structured interviews and conducted 40 observations of SITs multidisciplinary team meetings. Reflexive Thematic Analysis was applied to analyze the transcripts both deductively and inductively. Four categories of facilitators and barriers for interprofessional decision-making within SITs (on the professional, team, and organizational level) and with other care services were formulated: (1) organizing decision-making, (2) dealing with differing opinions, (3) motivation for interprofessional decision-making, and (4) embedding interprofessional decision-making in SDM with families. In SDM with families facing complex problems, professionals and services need to balance decision-making both in multidisciplinary teams and with other care services, considering a formal organization of decision-making, integrating professional perspectives, and keeping the family in the center of decision-making.

BACKGROUND: Integrated behavioral health care (IBH), a team-based approach to care, involves behavioral health providers (BHP) to be utilized in primary care settings. Unfortunately, many BHP and primary care advanced practice nursing students do not receive IBH content in their educational curriculum. This article describes an innovative interprofessional simulation project (ISP) in a virtual IBH setting with primary care nurse practitioner and master's level counseling students. METHOD: The ISP involved students role-playing using case studies while enacting the roles exemplified in the Collaborative Care model (CoCM). Interprofessional faculty collaborated in developing the project and training facilitators and interprofessional students. RESULTS: Of the students and faculty who completed a postsurvey, 87.7% reported an increase in preparedness in learning the CoCM, and 92.6% responded the preparation time for the project was "appropriate." CONCLUSION: The ISP project resulted in high satisfaction and perceived increased preparedness for students and faculty to practice and teach IBH. [J Nurs Educ. 2024; 63(X):XXX-XXX.].

INTRODUCTION: The profession of pharmacy has been continuously evolving, redefining scope of practice in every practice settings to meet the ongoing needs of the health care system and to meet patient expectations and need. Pharmacists are increasingly becoming part of primary care teams in countries such as Canada, the United Kingdom and Australia. In British Columbia, Canada, the Pharmacists in Primary Care Network (PCN) Program integrated primary care clinical pharmacists (PCCPs) as core members of the interprofessional team (IPT). The IPT members' experiences of collaborating with a pharmacist in a team-based primary care setting have not been extensively studied. AIM: To describe the experiences of IPT members and PCCPs while working collaboratively for the shared care of mutual patients to identify the enablers, barriers, and development of interprofessional collaborations within the primary care setting in a province-wide program. METHOD: Based upon the evaluation of the Pharmacists in the PCN Program, this work was informed by Qualitative Description methodology. Interview and focus group data were performed during two time periods (T1 and T2) of program implementation. Study participants included PCCPs, prescribers (family physicians and nurse practitioners), and PCN IPT members (social workers, dieticians, physiotherapists, and clinical counsellors). Each participant was invited via e-mail to attend a Zoom interview or focus group session. RESULTS: In T1 we interviewed 15 PCCPs and in T2, we interviewed 39 PCCPs, 12 IPT members and 11 prescribers. Data analysis developed four themes: (i) awareness shaping early acceptance and role clarity; (ii) deepening interprofessional collaboration over time; (iii) communication strategies which facilitated relationship building with the PCN providers; and (iv) impact of the co-location model on teamwork and improved care coordination. CONCLUSION: The interprofessional collaboration between PCCPs, prescribers, and IPT members was strengthened through efforts of relationship building, improved role clarity, and easily accessible communication methods. The PCN teams addressed the initial integration challenges and provided the support for effective shared patient care.

OBJECTIVE: The Children's Depression Rating Scale-Revised (CDRS-R) is widely used in clinical research to assess depression in adolescents; however, limited research explores its measurement properties. This study aimed to test the interrater reliability of the CDRS-R and describe the corresponding measurement error. METHOD: A cross-sectional design was used in the context of a controlled clinical trial. The sample consisted of help-seeking adolescents (N = 55, ages 13-18 years, inclusive) experiencing depressive symptoms. A research analyst administered and coded the CDRS-R to adolescents through a virtual video-based platform with audio and video recordings. A second research analyst independently watched and coded recordings. The lower bound of the 95% CI of the intraclass correlation coefficient with respect to absolute agreement between 2 independent raters was hypothesized to be ≥0.70. RESULTS: The reliability of CDRS-R was calculated as an intraclass correlation coefficient of 0.84 (95% CI 0.71 to 0.91), indicating acceptable reliability. The associated standard error of measurement was 4.67, and the mean difference in scores between raters was 1.13. The limits of agreement were -11.59 to 13.84. CONCLUSION: The findings provide support for the CDRS-R as a tool with adequate interrater reliability to assess depressive symptoms in adolescents. The measurement error parameters can assist in clinical interpretation of differences in scores when adolescents are assessed by multiple raters. CLINICAL TRIAL REGISTRATION INFORMATION: Effectiveness of an Integrated Care Pathway for Depression: Cluster Randomized Controlled Trial (CARIBOU-2); https://clinicaltrials.gov/study/NCT05142683.; This study evaluated the reliability of the Childhood Depression Rating Scale-Revised (CDRS-R), a common interview tool used to assess depression among youth. Researchers found strong agreement among different raters, with a high statistical reliability score of 0.84. These results suggest that the CDRS-R is a consistently reliable assessment tool.; eng