Pilot of a team-based quality improvement strategy to improve cardiovascular risk factors care in community mental health centers
IntroductionPopulations with serious mental illness are less likely to receive evidence-based care for cardiovascular disease (CVD) risk factors. We sought to characterize the implementation of an adapted team-based quality improvement strategy to improve mental health providers’ delivery of evidenc...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1446985/full |
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| author | Karly A. Murphy Karly A. Murphy Joseph Gennusa Arlene T. Dalcin Arlene T. Dalcin Courtney Cook Courtney Cook Stacy Goldsholl Tyler Fink Gail L. Daumit Gail L. Daumit Gail L. Daumit Gail L. Daumit Gail L. Daumit Gail L. Daumit Nae-Yuh Wang Nae-Yuh Wang Nae-Yuh Wang Nae-Yuh Wang Nae-Yuh Wang David Thompson David Thompson Emma E. McGinty |
| author_facet | Karly A. Murphy Karly A. Murphy Joseph Gennusa Arlene T. Dalcin Arlene T. Dalcin Courtney Cook Courtney Cook Stacy Goldsholl Tyler Fink Gail L. Daumit Gail L. Daumit Gail L. Daumit Gail L. Daumit Gail L. Daumit Gail L. Daumit Nae-Yuh Wang Nae-Yuh Wang Nae-Yuh Wang Nae-Yuh Wang Nae-Yuh Wang David Thompson David Thompson Emma E. McGinty |
| author_sort | Karly A. Murphy |
| collection | DOAJ |
| description | IntroductionPopulations with serious mental illness are less likely to receive evidence-based care for cardiovascular disease (CVD) risk factors. We sought to characterize the implementation of an adapted team-based quality improvement strategy to improve mental health providers’ delivery of evidence-based CVD risk factor care.MethodsIn a 12-month, single arm pre/post pilot study in four behavioral health homes embedded within psychiatric rehabilitation programs, sites implemented an adapted Comprehensive Unit Safety Program (CUSP). Primary measures examined changes in organizational quality improvement culture and provider self-efficacy for CVD risk factor care. Secondary measures examined changes in acceptability, appropriateness, and feasibility of CUSP and receipt of guideline-concordant care for hypertension, dyslipidemia, and diabetes.ResultsProvider self-efficacy to coordinate care for hypertension and diabetes improved, but organizational quality improvement culture did not change. Acceptability, appropriateness, and feasibility were rated highly but did not change pre/post CUSP. The percentage who reached goals per national guidelines improved for those with dyslipidemia but not for those with hypertension or diabetes. CUSP teams implemented processes to build staff capacity, standardize communication, elicit feedback, and deliver education on coordination for CVD risk factors.ConclusionThis pilot study showed no effects of CUSP on organizational quality improvement culture or provider self-efficacy, the mechanisms by which CUSP is expected to improve care processes. Long term investments are needed to support organizational quality improvement work and providers’ efficacy to delivery - evidence-based CVD risk factor care delivery.Clinical Trial Registrationhttp://www.ClinicalTrials.gov, identifier NCT04696653. |
| format | Article |
| id | doaj-art-5f7b67a1ba59413fbb817951d75ba415 |
| institution | Kabale University |
| issn | 1664-0640 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj-art-5f7b67a1ba59413fbb817951d75ba4152025-01-31T06:40:11ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-01-011610.3389/fpsyt.2025.14469851446985Pilot of a team-based quality improvement strategy to improve cardiovascular risk factors care in community mental health centersKarly A. Murphy0Karly A. Murphy1Joseph Gennusa2Arlene T. Dalcin3Arlene T. Dalcin4Courtney Cook5Courtney Cook6Stacy Goldsholl7Tyler Fink8Gail L. Daumit9Gail L. Daumit10Gail L. Daumit11Gail L. Daumit12Gail L. Daumit13Gail L. Daumit14Nae-Yuh Wang15Nae-Yuh Wang16Nae-Yuh Wang17Nae-Yuh Wang18Nae-Yuh Wang19David Thompson20David Thompson21Emma E. McGinty22Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, United StatesMultiethnic Health Equity Research Center, University of California, San Francisco, San Francisco, CA, United StatesDivision of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United StatesDivision of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United StatesWelch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, United StatesDivision of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United StatesWelch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, United StatesDivision of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United StatesDivision of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United StatesDivision of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United StatesWelch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, United StatesDepartment of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United StatesDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United StatesDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United StatesDepartment of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United StatesDivision of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United StatesWelch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, United StatesDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United StatesDepartment of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States0Institute for Clinical and Translational Research, Johns Hopkins University, Baltimore, MD, United States1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States2Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD, United States3Division of Health Policy and Economics, Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, United StatesIntroductionPopulations with serious mental illness are less likely to receive evidence-based care for cardiovascular disease (CVD) risk factors. We sought to characterize the implementation of an adapted team-based quality improvement strategy to improve mental health providers’ delivery of evidence-based CVD risk factor care.MethodsIn a 12-month, single arm pre/post pilot study in four behavioral health homes embedded within psychiatric rehabilitation programs, sites implemented an adapted Comprehensive Unit Safety Program (CUSP). Primary measures examined changes in organizational quality improvement culture and provider self-efficacy for CVD risk factor care. Secondary measures examined changes in acceptability, appropriateness, and feasibility of CUSP and receipt of guideline-concordant care for hypertension, dyslipidemia, and diabetes.ResultsProvider self-efficacy to coordinate care for hypertension and diabetes improved, but organizational quality improvement culture did not change. Acceptability, appropriateness, and feasibility were rated highly but did not change pre/post CUSP. The percentage who reached goals per national guidelines improved for those with dyslipidemia but not for those with hypertension or diabetes. CUSP teams implemented processes to build staff capacity, standardize communication, elicit feedback, and deliver education on coordination for CVD risk factors.ConclusionThis pilot study showed no effects of CUSP on organizational quality improvement culture or provider self-efficacy, the mechanisms by which CUSP is expected to improve care processes. Long term investments are needed to support organizational quality improvement work and providers’ efficacy to delivery - evidence-based CVD risk factor care delivery.Clinical Trial Registrationhttp://www.ClinicalTrials.gov, identifier NCT04696653.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1446985/fullserious mental illnesscardiovascular riskquality improvementcare coordinationprimary careteam-based care |
| spellingShingle | Karly A. Murphy Karly A. Murphy Joseph Gennusa Arlene T. Dalcin Arlene T. Dalcin Courtney Cook Courtney Cook Stacy Goldsholl Tyler Fink Gail L. Daumit Gail L. Daumit Gail L. Daumit Gail L. Daumit Gail L. Daumit Gail L. Daumit Nae-Yuh Wang Nae-Yuh Wang Nae-Yuh Wang Nae-Yuh Wang Nae-Yuh Wang David Thompson David Thompson Emma E. McGinty Pilot of a team-based quality improvement strategy to improve cardiovascular risk factors care in community mental health centers Frontiers in Psychiatry serious mental illness cardiovascular risk quality improvement care coordination primary care team-based care |
| title | Pilot of a team-based quality improvement strategy to improve cardiovascular risk factors care in community mental health centers |
| title_full | Pilot of a team-based quality improvement strategy to improve cardiovascular risk factors care in community mental health centers |
| title_fullStr | Pilot of a team-based quality improvement strategy to improve cardiovascular risk factors care in community mental health centers |
| title_full_unstemmed | Pilot of a team-based quality improvement strategy to improve cardiovascular risk factors care in community mental health centers |
| title_short | Pilot of a team-based quality improvement strategy to improve cardiovascular risk factors care in community mental health centers |
| title_sort | pilot of a team based quality improvement strategy to improve cardiovascular risk factors care in community mental health centers |
| topic | serious mental illness cardiovascular risk quality improvement care coordination primary care team-based care |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1446985/full |
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