Core Topics in Preparing, Implementing, and Sustaining Services
CMHIS and our bi-regional Hubs can help your organization or system improve the delivery of mental health care by supporting you in preparing, implementing, and sustaining effective prevention, treatment, and recovery programs and services.
We offer support in the following areas:
Engaging the community and assessing their mental health needs is vital before selecting a new program or practice to implement. The needs assessment will identify: community mental health needs, strengths, and their underlying factors; existing mental health services and gaps; and solutions to address these needs. Engaging people from the target community in the needs assessment is essential, and with their partnership designing, providing, and evaluating programs and practices can better address needs.
Factors influencing implementation are things that inform, support (facilitators), or hinder (barriers) efforts to deliver effective practices and maintain them over time. They can include characteristics of the practice; the people involved; clinics, organizations, systems, and communities; and other factors. Understanding these facilitators, barriers, and other influences can be essential for deciding what practice to use for a specific mental health need, improving its fit for a setting and community, and making the practice work and last. Factors influencing implementation are sometimes referred to as barriers/facilitators or contextual determinants.
Implementation strategies are supports, methods, or techniques used to produce or sustain practice change. Sometimes these strategies are delivered by experts from outside an organization, and other times delivered “in house” by designated employees of the organization. The most common implementation strategy is training. Other frequently used strategies are expert consultation, modifying workflow, or providing incentives. Implementation strategies are most effective when they intentionally address factors that influence implementation and when they aim for meaningful and measurable outcomes. Implementation strategies are also called implementation supports or technical assistance.
Measurement-based care (MBC) takes a clinical approach using regularly collected, patient-reported outcome measures to monitor progress and guide treatment decisions. These data track how a patient is responding to treatment and allows treatment to be adjusted for individuals who are not getting better. Measurement-Based Care makes it possible to help clinicians and patients make informed decisions together, adjusting treatments based on real-time data to improve outcomes.
Communication and social marketing solutions help organizations reach their key audiences, such as individuals who may benefit from certain mental health services. Marketing strategies can be used to both promote services and influence positive behavioral change. Through strategic communication and marketing, organizations can deliver effective messages that engage their audiences, support practice improvements, and lead to positive mental health outcomes.
Continuous Quality Improvement (CQI) is a structured approach to quality that uses data to improve organizational systems, processes, service delivery, and outcomes. It is a form of process improvement in which an individual or team sets a goal for improvement, enacts a change, measures the effect of the change, and repeats this process until the goal is met.
Program evaluation is a planned, systematic process of assessing the different elements of a program or service in terms of its effectiveness, efficiency, and overall impact. This includes collecting and analyzing data related to the program’s goals, objectives, and short- and long-term outcomes. It assesses how well the program was implemented and how effective it was at accomplishing its intended purpose. Program evaluation helps us understand not just if a program or service is successful but why and what is contributing to its success (or lack thereof). Program evaluation also should tie back to the community mental health needs assessment results and examine whether gaps are being met.
Sustaining service delivery involves developing strategies to continue providing a mental health service or program over time while achieving consistent, positive patient outcomes for all. Sustaining effective programs requires careful planning and continued attention to funding, partnerships, and resources. Sustainability refers to the extent to which effective programs and practices can continue to be delivered over time, are institutionalized within settings, and have the necessary capacity to support their delivery. Sustainment refers to the continued use of an effective practice given the resources available.