Potential Scrum Targets
- Diagnoses – How can we ensure consistent and accurate patient diagnoses?
- Safety – given the rise in violence at community mental health centers, how can we address safety concerns at the center?
- Involuntary Commitments – in light of California’s new legislation that allows the involuntary treatment of more people with severe mental illnesses. It expands the legal definition by which someone can be deemed “gravely disabled” and treated against their will. The new, expanded definition allows for consideration of whether a person fails to provide for their own medical care or personal safety. It includes not just mental illness, but also severe substance use disorder and chronic alcoholism. The dangers in this bill are evident. Even aside from civil liberties concerns, studies on the effectiveness of involuntary treatment in improving symptoms are inconclusive. Hospitalization can even be counterproductive: Significant numbers of people leave psychiatric units traumatized, suicidal and uninterested in further treatment.
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The objective of this Community of Practice (CoP) Thought-Leadership Group is to:
— Provide patients with the most effective treatments to improve patient outcomes;
— Increase the effectiveness of mental illness’ diagnosis and treatments;
— Collaborate and knowledge-sharing with colleagues for the benefit of all.
We are committed to community engagement, stigma reduction, and ensuring equitable, cutting-edge treatments are available to all patients.
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Survey conducted at NatCon23:
Which of the following would you like to see improved upon at your CMHC:
If you could change one thing about the patient care at your CMHC, what would it be? (This question is specific to PATIENT CARE and could include responses such as faster or more accurate or more consistent diagnosis; better or more consistent treatment for a given diagnosis; access to cutting-edge treatments, etc.)
What is the greatest challenge you face at your CMHC?
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One way to see immediate change is by including research as an option for your patients.
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References:
Boaz A, Hanney S, Jones T, Soper B. Does the engagement of clinicians and organisations in research improve healthcare performance: a three-stage review. BMJ Open. 2015
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Rowley E, Morriss R, Currie G, Schneider J. Research into practice: Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Nottinghamshire, Derbyshire, Lincolnshire (NDL). Implement Sci. 2012
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Gold M, Taylor EF. Moving research into practice: lessons from the US Agency for Healthcare Research and Quality’s IDSRN program. Implement Sci. 2007
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Davis MM, Gunn R, Gowen LK, Miller BF, Green LA, Cohen DJ. A qualitative study of patient experiences of care in integrated behavioral health and primary care settings: more similar than different. Transl Behav Med. 2018
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van’t Hoff W, Selvaratnam W. Recognising research: how research improves patient care. RCP 2018 at https://www.rcplondon.ac.uk/news/recognising-research-how-research-improves-patient-care
Why introduce research into a Community Mental Health Center? It can be costly, time-consuming, and pose many ethical challenges. It may cause friction if some staff are resistant, and resentment if others are not given the resources to conduct the research they want.
Given these (and other) concerns, how can a CMHC justify taking on the challenge of integrating research into their organization?
To start with, research is essential to achieving breakthroughs in earlier and more accurate diagnoses, more effective treatments, and the prevention of ill health and co-morbidities. Only with research can there be new treatments.
Data shows that engaging in research studies and the scientific approach results in improved patient care and increased job satisfaction for staff. Research benefits the whole organization, as hospitals and health centers that participate in research have demonstrated better health outcomes including lower mortality rates.
The STARR Coalition’s Community of Practice (CoP) was established to support the integration of research in CMHCs and increase participation from more diverse and traditionally underrepresented communities. Our definition of research includes testing new products, examining existing services and care pathways, and improving the way those services are set up and run. All healthcare workers can contribute to research in areas where they see a need. And this may involve introducing both research and the research mindset in treatment pathways to improve care which, in turn, can lead to a faster return to everyday life for patients.
Our CoP will support CMHCs taking a organization-wide community approach to research, making it more efficient, inclusive, and equitable. The CoP will create a network of peers from many CMHCs, developing a comprehensive set of resources, from templates to diagnostics, and providing educational opportunities, such as webinars and workshops to share best practices.
We believe that including research as an option can improve outcomes and save lives.
The CoP will help healthcare workers practicing in CMHCs identify opportunities to be involved in research, while offering their patients the opportunity to learn about and possibly participate in suitable research. The CoP will provide the support, guidance, and information needed to enhance the career of healthcare workers involved in research. Participation in the CoP will enhance the CMHCs ability to attract high performing staff due to the added reputation of working in an institution that conducts research and offers cutting-edge methodologies.
Emails:
Please let me know if you are available for a CoP Advisory Board call on Monday, Sept. 25th or Friday, Sept. 29th.
As a reminder, the Community of Practice (CoP) thought leadership group is a community of leaders from community behavioral health centers across the country. The goals of our CoP are:
- Collaboration and knowledge-sharing with colleagues from other CBHCs for the benefit of all;
- Providing patients with the most effective treatments to improve patient outcomes;
- Increasing the effectiveness of mental health diagnosis and treatments.
You can find more information on the CoP here. I’m happy to jump on a call at any time to discuss this further, if you’d like.
Please let me know if you are available on the 25th or 29th and the best times for a call.
I look forward to hearing from you and working together to help WestCare — and CMHCs across the country – make the most of every opportunity to provide the absolute best care to those living with mental illnesses!
With thanks and warm regards,
Erica
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From: Erica Moore
Sent: Tuesday, August 15, 2023 3:36 PM
Subject: Community of Practice thought leadership group
It has been a few months since my last email, but I wanted to loop back to see if you had a few minutes for a quick call regarding the Community of Practice thought leadership group that we are building. I especially wanted your expertise on the board, given your success working with the community and with peer specialists.
I’ve included the original email with all of the details of the Community of Practice below and would love a 5-10 minute call to talk about how the thought leadership group could benefit your work at WestCare.
As much as I would like you to take the role on the board, if your bandwidth is too overburdened, I hope that you will consider recommending someone else from your group.
We are looking to initiate the first scrum this Fall, which would involve 3-4 monthly calls (minimizing the time commitment).
Please let me know if you have a few minutes to chat this week or if you would just like to be included on the board and kept in the loop.
I look forward to hearing from you!
With thanks and warm regards,
Erica
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From: Erica Moore
Sent: Monday, May 8, 2023 12:42 PM
Subject: Follow up from NatCon
It was a pleasure meeting you last week at NatCon! I attended your session on financing growth at WestCare Nevada (‘It Takes a Village’). I only got to speak with you very briefly at the end because you had several people waiting to speak with you. I want to say again how much I enjoyed your session and am so impressed with your team’s work!
I mentioned the Community of Practice (CoP) thought leadership group that we are building with leaders from community behavioral health centers across the country. I’m following up because I think that you would be a phenomenal addition to the group, given your experience and insight into community behavioral health systems.
The goals of our CoP are:
- Collaboration and knowledge-sharing with colleagues from other CBHCs for the benefit of all;
- Providing patients with the most effective treatments to improve patient outcomes;
- Increasing the effectiveness of mental health diagnosis and treatments.
Feedback from the survey (here) conducted at NatCon overwhelmingly indicated that workforce issues were the number one pain point at the community mental health centers (CMHCs): recruiting and retaining qualified staff, leading to understaffing and increased workloads. Finding innovative ways to recruit and retain staff will be one of the top priorities for our CoP.
We are targeting the end of June/July for our first meeting (via zoom). We will discuss priorities, workflow, scheduling, etc., along with other topics that the CoP members want to address.
You can find more information on the CoP here. I’m happy to jump on a call at any time to discuss this further, if you’d like.
I look forward to hearing from you and working together to help WestCare — and CMHCs across the country – make the most of every opportunity to provide the absolute best care to those living with mental illnesses!
Dear Erica,
Yes, it is lovely to reconnect. I hope you are keeping well.
I’m so glad you liked what you saw of ONL. Be warned it is a bit of a Hotel California, you might never want to leave…
You know your people better than anyone. If short scrums will appeal, then go with that. ‘Short and productive’ are great selling points!
If you can set specific dates for the scrums, it helps everyone plan. It also gives you a chance to see what worked well and bring that learning forward to the design of the next scrum.
If you have a website or page to promote the scrums anyway, you might consider adding some (open access?) material there that will be relevant to your audience – this could give them a sense of what they might expect from a scrum.
I’m not sure if you could see it on ONL, but each topic will have one page that has all relevant information freely available, including the scenario that we will work on over a 2 week period. See for example this page from the archives: https://www.opennetworkedlearning.se/onl231-course-overview/onl231-topic-3-learning-in-communities-networked-collaborative-learning/
So, there are lots of ways you can offer something of interest and hopefully, encourage people to participate as a result.
Regarding engagement, that can be tricky.
Be clear about expectations, especially time commitment and have support in place for learners. Who can they go to when they are stuck or unsure?
Apart from that, once learners realise how useful the scrum is to them, they will get on board. They need to see clearly how they could apply what they learn and how doing so will make their working day easier/better.
How it works in ONL is that an institution can send X number of participants. For every group of participants, the institution must also send a facilitator. The institutions pay facilitators for their time.
Facilitators have paperwork to do – they ensure that all participants from their institution are taking part and making progress. They check that any participation and output requirements are met and they sign off on the participants’ right to be awarded a certificate.
Each ONL group will have a facilitator and a co-facilitator. Co-facilitators are typically people who participated in ONL previously and fell in love with it (this is the Hotel California bit). Co-facilitators are not paid, but they gain a lot in terms of community and new ideas. They also get a certificate to acknowledge their contribution.
Best of luck with your plans! I’m excited for you.
Kind regards,
Sinéad
Sinéad Whitty (she/her)
Head of Training, Teaching and Career Development,
The Global Health Network,
Nuffield Department of Medicine, University of Oxford
Acting Course Director,
Postgraduate Diploma in Global Health Research
Dear Sinead,
It has been way, WAY too long and I’m so glad that we are finally re-connecting!
I did spend a bit of time on the ONL site after Jeremy told us about it on Saturday. I love it – it is, as you say, deceptively simple, yet powerful.
Based on what Jeremy may or may not have told you about our Community of Practice (CoP) for the community behavioral health centers (CBHC’s) in the US, do you think this would be a good model for us to pattern our group after?
I was thinking that we needed to pattern our website after the other CoPs that you’ve worked on – the ArchHub or the LactaHub, but I really like the ONL set up because of the scrums… my greatest worry with our CoP is lack of engagement — the short and productive scrums would be an easier pitch for our CBHC’s.
I started working on setting up a new domain for our CoP and reached out to our tech guy to see about helping me set up a new site. I hope to have the fundamentals in place before actually building a site and I’d love your input.
With thanks and warm regards,
Erica
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From: Sinead Whitty
Sent: Monday, August 14, 2023 8:54 AM
Subject: Re: ONL
Dear Erica and Jim,
ONL is a course/community, run by a small, dedicated team from a consortium of universities, most of which are based in Scandinavia.
People join from all over the world and all are welcome. Participants tend to have an interest in education, but apart from that, backgrounds vary.
ONL has a deceptively simple design but the learning is powerful. And the sense of belonging along the way is beautiful.
There are lots of possible ways to interact with ONL:
- actively participate in a small group (most time consuming and most fun, but you get an instant network)
- actively participate as an individual
- simply engage with the open material and drop in to webinars or tweetchats.
Happy to chat further anytime.
Here’s a link to the course (being Scandi it is free of charge): https://www.opennetworkedlearning.se/onl232-course-overview/
Best regards,
Sinéad
Sinéad Whitty (she/her)
Head of Training, Teaching and Career Development,
The Global Health Network,
Nuffield Department of Medicine, University of Oxford
Acting Course Director,
Postgraduate Diploma in Global Health Research