Approaches to Measuring Quality Improvement in Public Health Series: Partnerships
March 24, 2020

Hello, and welcome to the fifth and final installment in our “Approaches to Measuring Quality Improvement in Public Health” series! While quality improvement principles have traditionally been implemented in clinical settings, this series is focused on unpacking a measurement framework to apply a Q.I model/lens to public health, systems-level work. In our most recent post, we focused on the Assessment, Measurement, and Monitoring piece of the framework.  The post highlighted the Vermont Adolescent and Young Adult Behavioral Health (AYA BH) CoIIN team’s efforts to take inventory of current related efforts across the states and to prioritize AYA BH needs by incorporating several relevant measures within their state Title V action plan.

For today’s entry, we’ll be zooming in on the Partnership piece of the QI framework.  This domain emphasizes the importance of developing new and/or enhancing existing relationships within state government and external entities as well as the value of coordinating efforts between partners.  Read on to learn how Indiana’s AYA BH CoIIN has operationalized this tenant of the framework.

Centering around Provider Capacity-Building: An Example of State-Level Partnerships in Indiana
By Steven Holland, Bureau Chief, Youth Services, Division of Mental Health and Addiction

In practice, many systems struggle with meaningful connections to other relevant partners. Often, the situation occurs where the right hand is not aware of what the left hand is doing. The Indiana AYA BH CoIIN team has a history of forming and maintaining key partnerships that goes back to their participation in the first iteration of this CoIIN project, which focused more generally on the uptake and quality of the Adolescent Well-Visit.  For the current iteration of the CoIIN project, which has a more specific focus on depression screenings within the well-visit, the team includes members from the State Department of Health, Division of Mental Health and Addiction, Medicaid/Anthem insurance, Indiana University, and Foster Success (a local agency that provides services to foster youth). In addition to the public health team partnerships, the Indiana team successfully recruited clinical partners around the state hungry for information about how to improve rates of depression screening with a follow up care plan for adolescents and young adults, ages 12 to 25. In all, 21 practices, primarily of Family Medicine, were recruited with 29 health care professionals participating to learn more about depression screening, evaluation, and treatment.

In an effort to support provider capacity to provide depression screenings for AYAs in their care, the Indiana CoIIN team has centered their current partnership around the development of a state mental health system webinar, which will educate clinical partners on the state resources that are available for behavioral health referrals and consultations. In planning for the content of this webinar, it has become increasingly apparent how valuable the various perspectives of the team members are. While each member has a piece of understanding on how the mental healthcare larger system works, they have only been able to fully address gaps and articulate a more comprehensive picture of the mental health care system in Indiana through incorporation of every team member’s knowledge. With the work being done on this webinar, each member of the team will walk away with a more comprehensive understanding of the state mental health system. This will not only create a more cohesive story and understanding of the mental health system among all CoIIN team members and participating clinicians, but it will also facilitate the sharing of information with team member’s respective agencies to inform future partnerships and decision-making.

Looking beyond the current project, continued development of the partnerships that make up the Indiana CoIIN has the ability to leave a lasting impact on Indiana’s youth and young adults as a whole. As our team works collectively to build support for the medical providers in the field, it is the Indiana CoIIN team’s hope that adolescents and young adults will be able to access behavioral health care more efficiently and effectively.