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Advanced Collaborative Care Skills: Practical Strategies for the Implementation and Sustainability of the Collaborative Care Model
Collaborative care (CoCM) is an evidence-based, integrated model for the treatment of common mental health conditions in medical settings. Efficacy of CoCM has been demonstrated by more than 80 RCTs. However, significant practice change is required to implement and sustain CoCM. This advanced skills course will draw on the presenters from the University of Washington’s (UW) Advancing Integrated Mental Health Solutions (AIMS) Center and Integrated Care Training Program. The presenters have significant expertise in CoCM clinical practice, team building, implementation and financing. Each section will have both a didactic and self-directed learning component. Session overview:
--Introduction to Implementation of the Collaborative Care Model (CoCM).
--Lay the Foundation - Defining the Vision and Obtaining Buy-in: Drawing from his work as the founder of the UW AIMS Center, Dr. Unutzer will discuss the importance of having a clear vision for CoCM and obtaining buy-in from key stakeholders.
--Plan for Clinical Practice Change - Using CoCM Codes: Dr. Carlo will explain key practice decisions in planning for CoCM implementation and the financial sustainability implications.
--Plan for Clinical Practice Change - Build CoCM Workflows: Dr. Chang will draw from experiences as UW CoCM BHIP Medical Director role and expertise in implementation support to review strategies to develop and refine CoCM workflows.
--Build Your Clinical Team - Train the CoCM team: As a CoCM consulting psychiatrist and educator, Dr. Toor will discuss important considerations when forming and training a CoCM clinical team.
--Launch and Deliver Quality Care - Monitor and improve performance using program-level quality metrics. Dr. Whitfield will draw from experiences as CoCM consulting psychiatrist and trainer and expertise in quality improvement methods to review key strategies for sustaining high-quality CoCM services.
--Sustain CoCM Care- Sustain CoCM by proactively addressing common barriers: Dr. Ratzliff will draw on her experience supporting sustainability of CoCM as the current co-director of the UW AIMS Center to discuss financial sustainability, team turnover and addressing CoCM fidelity.
Audience Interaction: All participants will develop an implementation/sustainability goal and next steps related to the content presented to be applied in their own practice.
1. Archer J, Bower P, Gilbody S, et al. Collaborative care for depression and anxiety problems. In: Archer J, ed. Cochrane Database of Systematic Reviews. Chichester, UK: John Wiley & Sons, Ltd; 2012:2-4.
2. Carlo AD, Unützer J, Ratzliff ADH, Cerimele JM. Financing for Collaborative Care—a Narrative Review. Curr Treat Options Psychiatry. July 2018:1-11.
3. Moise N et al. Sustainability of collaborative care management for depression in primary care settings with academic affiliations across New York State. Implement Sci. 2018 Oct 12;13(1):128.
4. Whitebird RR et al. Effective Implementation of collaborative care for depression: what is needed? Am J Manag Care. 2014 Sep;20(9):699-707.
--Introduction to Implementation of the Collaborative Care Model (CoCM).
--Lay the Foundation - Defining the Vision and Obtaining Buy-in: Drawing from his work as the founder of the UW AIMS Center, Dr. Unutzer will discuss the importance of having a clear vision for CoCM and obtaining buy-in from key stakeholders.
--Plan for Clinical Practice Change - Using CoCM Codes: Dr. Carlo will explain key practice decisions in planning for CoCM implementation and the financial sustainability implications.
--Plan for Clinical Practice Change - Build CoCM Workflows: Dr. Chang will draw from experiences as UW CoCM BHIP Medical Director role and expertise in implementation support to review strategies to develop and refine CoCM workflows.
--Build Your Clinical Team - Train the CoCM team: As a CoCM consulting psychiatrist and educator, Dr. Toor will discuss important considerations when forming and training a CoCM clinical team.
--Launch and Deliver Quality Care - Monitor and improve performance using program-level quality metrics. Dr. Whitfield will draw from experiences as CoCM consulting psychiatrist and trainer and expertise in quality improvement methods to review key strategies for sustaining high-quality CoCM services.
--Sustain CoCM Care- Sustain CoCM by proactively addressing common barriers: Dr. Ratzliff will draw on her experience supporting sustainability of CoCM as the current co-director of the UW AIMS Center to discuss financial sustainability, team turnover and addressing CoCM fidelity.
Audience Interaction: All participants will develop an implementation/sustainability goal and next steps related to the content presented to be applied in their own practice.
1. Archer J, Bower P, Gilbody S, et al. Collaborative care for depression and anxiety problems. In: Archer J, ed. Cochrane Database of Systematic Reviews. Chichester, UK: John Wiley & Sons, Ltd; 2012:2-4.
2. Carlo AD, Unützer J, Ratzliff ADH, Cerimele JM. Financing for Collaborative Care—a Narrative Review. Curr Treat Options Psychiatry. July 2018:1-11.
3. Moise N et al. Sustainability of collaborative care management for depression in primary care settings with academic affiliations across New York State. Implement Sci. 2018 Oct 12;13(1):128.
4. Whitebird RR et al. Effective Implementation of collaborative care for depression: what is needed? Am J Manag Care. 2014 Sep;20(9):699-707.
Speakers
Anna Ratzliff
Professor | University of Washington
Dr. Anna Ratzliff is a national expert on collaborative care and specifically, on training teams to implement and deliver mental health treatment in primary care settings. Her passion for translating complex research ideas into practical real-world applications began when she received her MD and PhD in Anatomy and Neurobiology as part of the Medical Scientist Training Program at the University of California at Irvine. She currently is a Professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington where she has developed additional expertise in suicide prevention training, mental health workforce development, adult learning best practices, and mentorship. Dr. Ratzliff is the Director of the UW Psychiatry Resident Training Program, Co-Director of the AIMS Center (Advancing Integrated Mental Health Solutions) and Director of the UW Integrated Care Training Program for residents and fellows. For more information on collaborative care please visit the AIMS Center Website (aims.uw.edu), the UW Integrated Care Training Program (ictp.uw.edu).
Jurgen Unutzer
Professor and Chair of Psychiatry | University of Washington
Dr. Unutzer is Professor and Chair of Psychiatry at the University of Washington. He also directs the Garvey Institute for Brain Health Solutions and he serves as an adjunct professor in the departments of Health Services and Global Health at the University of Washington. He is best know for his work on the IMPACT study, the largest trial of collaborative care to date and for founding the AIMS Center (Advancing Integrated Mental Health Solutions) which has helped more than 1,000 clinics around the world implement evidence-based collaborative care programs.
Andrew Carlo
Part-Time Assistant Professor | Northwestern Feinberg School of Medicine
Andrew D. Carlo, MD MPH is the Meadows Mental Health Policy Institute Senior Medical Director for Health System Integration and is an adult psychiatrist with extensive experience in physical and behavioral health integration. He is an actively practicing adult outpatient clinician. Dr. Carlo also has extensive research experience in the areas of health services and health policy, with a particular focus on behavioral health integration and the Collaborative Care model. His work has been published extensively in peer-reviewed journals, including JAMA, JAMA Psychiatry, Psychiatric Services, Health Affairs and the Journal of General Internal Medicine. Additionally, Dr. Carlo has given scholarly talks at many national conferences, including the annual meetings of the American Psychiatric Association, the Academy of Consultation-Liaison Psychiatry, Academy Health, and the Institute for Psychiatric Services. Dr. Carlo is primarily driven by his goals of achieving behavioral health equity and increasing access to high-quality, evidence-based mental health care for all people.
In addition to working at Meadows, Dr. Carlo is a part-time Assistant Professor at Northwestern Feinberg School of Medicine in Chicago. He graduated from Georgetown University School of Medicine and completed his residency training in adult psychiatry at Harvard Massachusetts General Hospital/McLean Hospital. Dr. Carlo then received his Master of Public Health Degree as part of his post-doctoral training in primary care psychiatry research at the University of Washington. Finally, Dr. Carlo served as the Academy Health National Health Policy Scholar from 2019-2020 and is an active member of the Early Career Advisory Committee for Psychiatric Services.
In addition to working at Meadows, Dr. Carlo is a part-time Assistant Professor at Northwestern Feinberg School of Medicine in Chicago. He graduated from Georgetown University School of Medicine and completed his residency training in adult psychiatry at Harvard Massachusetts General Hospital/McLean Hospital. Dr. Carlo then received his Master of Public Health Degree as part of his post-doctoral training in primary care psychiatry research at the University of Washington. Finally, Dr. Carlo served as the Academy Health National Health Policy Scholar from 2019-2020 and is an active member of the Early Career Advisory Committee for Psychiatric Services.
Jessica Whitfield
Acting Assistant Professor | University of Washington School of Medicine
Jessica Whitfield, MD, MPH, serves as an Acting Assistant Professor in the Psychiatry & Behavioral Sciences at the University of Washington School of Medicine, and Core Faculty at the Advancing Integrated Mental Health Solutions (AIMS) Center. She provides clinical care as a psychiatric consultant in UW’s Outpatient Collaborative Care program as well as serving as a psychiatric consultant coach for various regional and national collaborative care implementation projects with the AIMS Center. She also provides program assistance for UW’s Integrated Care Training Program as a supervisor and coordinator for Collaborative Care rotations within the UW Psychiatry Residency Program. Prior to her work as faculty, she completed her residency in General Adult Psychiatry at Brown University as well as the Integrated Care Training Program Fellowship at UW.
Ramanpreet Toor
Assistant Professor | University of Washington
Dr. Ramanpreet Toor is an Assistant Professor at University of Washington (UW). At UW she is Director of Integrated Care Fellowship, Faculty Lead for integrated care training for residents and Faculty Lead for online didactic curriculum for Community Based Fellowship. She also leads the Integrated Care Interest Pathway for psychiatry residents at UW. Clinically she works as a psychiatric consultant in Primary care clinics and Perinatal psychiatric consultant for PAL for Mom phone consultation line. She completed her Psychiatry Residency at Baystate Medical Center and Consultation-Liaison Psychiatry fellowship at Cambridge Health Alliance. Her interests include population health, delirium and perinatal psychiatry.
Denise Chang
Clinical Associate Professor | University of Washington
Dr. Denise Chang is a psychiatrist and Clinical Associate Professor in the School of Medicine at the University of Washington. Dr. Chang completed her medical degree at the University of Iowa and then went on to complete residency training in psychiatry at the University of Washington. She then pursued a fellowship in Consult-Liaison Psychiatry, also at the University of Washington. Following fellowship, she started on the faculty at the University of Washington, working as a psychiatric consultant for primary care clinics working within a Collaborative Care model. She is now the Medical Director of the Behavioral Health Integration Program, the University of Washington’s Collaborative Care program. She also is a part of the Integrated Care Training Fellowship program that trains psychiatrists and other health care providers in Collaborative Care. Dr. Chang also has substantial experience in quality improvement work and was the Medical Lead for the Depression Population Approach to Health project at the University of Washington, which was part of a larger Transforming Clinical Practice Initiatives grant from the Center of Medicare and Medicaid Services
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