Using a Learning Collaborative Model to Improve Youth Psychiatric Residential Treatment

ABSTRACT

As part of a transformation initiative, a behavioral health managed care organization partnered with 14 youth psychiatric residential treatment facilities (PRTFs) through a Learning Collaborative to support clinical training, family engagement, community integration, and medication monitoring. Self-reported progress toward sustainable implementation, monitored monthly, improved significantly over time (F = 15.05, p < .0001). Clinical and direct care PRTF staff (N = 1,580) received either in-person or virtual clinical training. Scores on a pre- and post-training knowledge test increased significantly for both in-person and virtual training (p < .001 for both), and training satisfaction was high. Percentage of youth with therapeutic family sessions per month did not change over the Learning Collaborative; this percentage began and remained high (Range: 90.71% to 93.37%). Strategies to engage youth and families in organizational governance increased significantly (e.g. including youth/family partners on staff and in program development). The number of partnerships between PRTFs and community-based behavioral health providers did not change over time. Instead, number of partnerships began and remained high (Range: 38.36 to 48.08). PRTFs also tracked medications monthly to develop internal systems to monitor prescribing practices. This study highlights the value of partnerships and the Learning Collaborative approach to support a continuous quality improvement process.

KEYWORDS:

• Psychiatric residential treatment facility
• learning collaborative
• medicaid
• behavioral health managed care

Acknowledgment

The authors gratefully acknowledge the contributions of Jeff Blau, L.C.S.W., Joel Brecht, M.A., C.R.C., L.P.C., Tiberiu Bodea Crisan, M.D, David Dan, M.S.W., Jodi Foster, B.A., James Gavin, M.S.W., Neil Glover, M.Ed., Gail Hofbauer, M.S., Shari Hutchison, M.S., P.M.P., Irina Karpov, M.S., Jennifer Keefer, B.A. Wendy Luckenbill, B.A., Diane Lyle, M.T.-B.C., L.P.C., Amanda Maise, M.S.P.H., Gina Russo, M.A., and Teri Stanley M. S., L.B.S. We are also grateful to the counties and primary contractors with whom we work as well as the Pennsylvania Office of Mental Health and Substance Abuse Services; the Youth and Family Training Institute; and the UPMC Center for High Value HealthCare; each of whom assisted in the development, implementation, and evaluation of the program. We also acknowledge and greatly appreciate the time and effort of the 14 provider organizations who participated in the Learning Collaborative, all of whom showed incredible resilience through their continued participation during the COVID-19 pandemic.

Disclosure statement

No potential conflict of interest was reported by the author(s).