Envisioning Transformation in VA Mental Health Services Through Collaborative Site Visits.

This column reviews the unique contributions of multiple partners in establishing a standardized site visit process to promote quality improvement in mental health care at the Veterans Health Administration. Working as a team, leaders in policy and operations, staff of research centers, and regional- and facility-level mental health leaders developed a standardized protocol for evaluating mental health services at each site and using the data to help implement policy goals. The authors discuss the challenges experienced and lessons learned in this systemwide process and how this information can be part of a framework for improving mental health services on a national level.

Mental health productivity monitoring in the Veterans Health Administration: Challenges and lessons learned.

Achieving quality outcomes and cost efficiency within mental health are overarching objectives of the Veterans Health Administration (VHA). The mental health care workforce has long been oriented toward the goal of high quality outcomes; however, cost efficiency has only recently been elevated into this important value equation. With increased demand for access to mental health services within the VHA, leadership sought to advance methods of determining and improving mental health provider productivity.

Research & services partnerships: lessons learned through a national partnership between clinical leaders and researchers.

This column describes lessons learned by U.S. Department of Veterans Affairs (VA) researchers and clinical operations managers while they were engaged in a unique partnership.

VHA mental health information system: applying health information technology to monitor and facilitate implementation of VHA Uniform Mental Health Services Handbook requirements.

Aim: To describe the design and deployment of health information technology to support implementation of mental health services policy requirements in the Veterans Health Administration (VHA).

Methods: Using administrative and self-report survey data, we developed and fielded metrics regarding implementation of the requirements delineated in the VHA Uniform Mental Health Services Handbook. Finalized metrics were incorporated into 2 external facilitation-based quality improvement programs led by the VHA Mental Health Operations.

The description and evaluation of the implementation of an integrated healthcare model.

Two studies were conducted to examine the practical implementation of an integrated health care model in five primary care clinics in the Upstate New York Veterans Affairs (VA) system. The aims of the studies were: (a) to describe the basic clinical elements of the integrated health care service offered by behavioral health providers (BHPs) in the primary care setting, and (b) to evaluate the perceptions of providers and patients regarding integrated health care practices in their primary care clinics. In Study 1, we reviewed 180 electronic medical records of patients who met with a BHP in primary care.

Identifying PTSD in primary care: comparison of the Primary Care-PTSD screen (PC-PTSD) and the General Health Questionnaire-12 (GHQ).

The aim of this study was to compare the PC-PTSD and GHQ-12 in detecting new cases of PTSD among primary care patients. Data on the PC-PTSD, GHQ-12 and psychiatric diagnoses was extracted from clinical databases for 11,230 VA primary care patients. Signal detection analyses and likelihood ratios were used to compare screens.