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ABSTRACT
Primary care (PC) settings increasingly use team-based care activities with embedded behavioral health providers (BHPs) to enhance patient care via group medical visits, conjoint appointments, team huddles, and warm handoffs. Aim 1 was to describe the variation of team-based care activities within integrated PC clinics. Aim 2 was to explore whether factors associated with the BHP (e.g., gender, training, and experience) and the PC setting (e.g., perceived teamwork) predict engagement in team-based activities. A national sample of eligible BHPs (n = 345; 14.2% response rate) completed an anonymous survey assessing the presence/intensity of team-based care activities. 90% of BHPs reported regularly engaging in team-based care activities with PC teams. Most engagement occurred when providing feedback to PC providers (90.4% at least daily) and during warm handoffs (90.4% at least once daily). Engagement in team-based care was predicted by the level of teamwork occurring within the PC clinic (βs = .41-.47; ps < .001) and BHP characteristics, such as the number of years spent in PC (βs = .24-.26, ps < .001). Although these data are promising, with many BHPs reportedly engaging in team-based activities with PC teams, there is significant variation. Researchers should continue to explore whether the engagement in these team-based care activities enhances patient care.
Acknowledgments
This study was supported with resources and the use of facilities at the VA Center for Integrated Healthcare. The information provided in this study does not represent the views of the Department of Veterans Affairs or the United States Government.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Data Availability statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Notes
1. This response rate was calculated very conservatively with the denominator being every person on each listserv. However, there are many people on the listservs who would not have been eligible to participate (i.e., those who are not embedded BHPs at least 20 hours/week, those who are not embedded BHPs but are administrators, trainees, or other members of primary care teams) and there are likely individuals who are on more than one listserv. We are unable to access data to determine exactly how many unique and eligible individuals are on the listservs we used to recruit. As such, our response rate of eligible individuals is likely much higher than 14.2%, but to err on the side of caution we are using the most conservative estimate.
Additional information
Funding
Notes on contributors
Jennifer S. Funderburk
Jennifer S. Funderburk is a clinical research psychologist, who studies various aspects of integrating behavioral health into primary care including the development and implementation of brief behavioral and team-based interventions to improve care of primary care patients.
Julie C. Gass
Julie C. Gass is a clinical research psychologist and behavioral health provider who is interested in studying innovative ways for integrated teams to provide care to patients, especially those with comorbid behavioral and medical health conditions.
Jennifer M. Wray
Jennifer M. Wray is the section chief of Suicide Prevention at the Ralph H Johnson VA Medical Center with research interests in the areas of suicide prevention and integrated care.
Robyn L. Shepardson
Robyn L. Shepardson is a clinical research psychologist who studies the development, evaluation, and implementation of brief behavioral interventions for use in integrated primary care settings.