Covid 19 Clinical Trials

Adequate access to mental health is one of the most important problems facing the VA and VISN 19. Mental health patients who are stabilized and recovered should be transitioned back to primary care to increase availability in mental health for new patients, and to signal to recovered patients that they are successfully recovered. Because there are currently no methods to identify who is recovered or tools and processes to assist in transitions, few patients 'graduate' mental health. The FLOW program consists of an algorithm to identify patients who are potentially appropriate for transition, a user-friendly online report to communicate this information to providers, materials to explain this process to patients and providers, and an electronic medical record (EMR) note template to document the transition. The investigators are partnering with VISN 19 to evaluate this program using a stepped wedge design with 9 sites randomly allocated into 3 steps in the wedge. Sites will receive an evidence-based implementation facilitation approach. The investigators will evaluate the number of patients transitioned, success of those transitions, and patient and provider satisfaction.

NCT04193033 Mental Health Other: FLOW intervention

Primary Outcomes

Description: Percent of mental health patients in each of the participating clinics who are transitioned to primary care through use of the FLOW intervention, based upon electronic medical record data documenting this transition

Measure: Reach: Percent of specialty mental health patients transitioned to primary care

Time: Change from baseline to 12 months

Description: Change in the VA publically reported metric "Percent of patients receiving an appointment within 7 days of the requested date" from baseline to 12 months

Measure: Effectiveness of intervention's impact on clinic access

Time: Change from baseline to 12 months

Description: Percent of mental health providers who use the FLOW intervention for at least 1 patient, compared to the total number of mental health providers in the participating clinics

Measure: Adoption: Percent of mental health providers who use FLOW intervention

Time: 12 months

Description: Percent if all FLOW components implemented as designed, based upon the items in the FLOW implementation checklist

Measure: Implementation fidelity to the protocol

Time: 12 months

Secondary Outcomes

Description: Change in the VA publically reported metric "Percent of patients receiving an appointment within 7 days of the requested date" from 12 to 24 months

Measure: Maintenance of Effectiveness of intervention's impact on clinic access

Time: 12-24 months

Description: Percent of all FLOW components implemented as designed, based upon the items in the FLOW implementation checklist, from 12 to 24 months

Measure: Maintenance of Implementation fidelity to the protocol

Time: 12-24 months

Description: Percent of mental health providers who use the FLOW intervention for at least 1 patient, compared to the total number of mental health providers in the participating clinics, from 12-24 months

Measure: Maintenance of Adoption: percentage of mental health providers who use FLOW intervention

Time: 12-24 months

Measure: Maintenance of Reach: percentage of specialty mental health patients transitioned to primary care

Time: from 12-24 months

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Clinical Trial MeSH HPO Drug Gene SNP Protein Mutation

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Clinical Trials

1 Evaluation of Implementing FLOW: Transitioning Stabilized Mental Health Patients to Management in Primary Care (PEC 19-302)

NCT04193033 Mental Health Other: FLOW intervention

Primary Outcomes

Secondary Outcomes

No related HPO nodes (Using clinical trials)