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Evaluation ViewAttendees 3

Category: Dissemination & Implementation Science

Symposium 150 - Fiscal, Organizational, and End-User Considerations for Improving Use of Evidence in Large Scale Healthcare Systems

Sunday, November 19, 2023
10:30 AM – 12:00 PM PST
Location: Sol Duc (708), Level 7
CE: 1.5

Keywords: Health Care System, Dissemination, Evidence-Based Practice
Level of Familiarity: Basic to Moderate
Recommended Readings: Dopp, A. R., Narcisse, M. R., Mundey, P., Silovsky, J. F., Smith, A. B., Mandell, D., Funderburk, B. W., Powell, B. J., Schmidt, S., Edwards, D., Luke, D., & Mendel, P. (2020). A scoping review of strategies for financing the implementation of evidence-based practices in behavioral health systems: State of the literature and future directions. Implementation Research and Practice. https://doi.org/10.1177/2633489520939980,   Okamura, K. H., Orimoto, T. E., Nakamura, B. J., Chang, B., Chorpita, B. F., & Beidas, R. S. (2020). A history of child and adolescent treatment through a distillation lens: Looking back to move forward. The Journal of Behavioral Health Services & Research, 47(1), 70–85. https://doi.org/10.1007/s11414-019-09659-3,   Schriger, S. H., Binagwaho, A., Keetile, M., Kerry, V., Mubiligi, J. M., Ramogola-Masire, D., Roland, M., Barg, F. K., & Cancedda, C. (2021). Hierarchy of qualities in global health partnerships: a path towards equity and sustainability. BMJ global health, 6(12), e007132. https://doi.org/10.1136/bmjgh-2021-007132,   Munson, S. A., Friedman, E. C., Osterhage, K., Allred, R., Pullmann, M. D., Areán, P. A., Lyon, A. R., & UW ALACRITY Center Researchers. (2022). Usability Issues in Evidence-Based Psychosocial Interventions and Implementation Strategies: Cross-project Analysis. Journal of Medical Internet Research, 24(6), e37585. https://doi.org/10.2196/37585,  

Dissemination and implementation (D&I) work has been prioritized as an essential component of improving the quality of clinical intervention services, and there has been much effort focused on helping healthcare systems to integrate evidence-based treatments (EBTs) into community health care. Despite revolutionary work done in this area, scientists, communities, healthcare system personnel, and policymakers still face many obstacles, particularly with large scale implementation into diverse and publicly-funded systems. When upscaling EBTs and other quality improvement efforts into entire states or countries, unique considerations emerge (or are at least greatly amplified in comparison to local efforts), such as financing and fiscal sustainability, state government branch coordination, and multi-contextual infrastructure development.  

This symposium brings together an array of presentations on topics typically understudied within traditional D&I efforts. Our first presenter will describe results from a mixed methods study investigating perspectives on financing strategies for supporting the implementation of EBTs, surveying expert representatives from youth mental health systems across the United States. Results demonstrated that experts tended to rely on strategies that were familiar but often did not sustainably support D&I. Our second presenter will discuss a pilot study examining the impact of a strategic fiscal planning tool (i.e., “Fiscal Mapping") on the financial sustainability of youth mental health treatment programs. The tool was found to improve strategic planning and funding stability under certain use cases. Our third presenter will showcase strategies for disseminating EBTs through the development of shared ontologies between various entities of state government, as well as D&I outcomes associated with their large multi-decade statewide effort. Our fourth presenter purposefully builds upon the third presentation and will describe an electronic case management system implementation in a statewide youth public mental system, highlighting staff practicality and usability perspectives. Lastly, our fifth presenter will share best practices that global health partnerships should consider to further increase their strength and improve their effectiveness and sustainability, while staying firmly committed to equity. The presentations will be summarized by a Discussant with expertise in the area of youth mental health EBT D&I with many years of firsthand experience serving in public mental health leadership positions (e.g., Director of statewide Behavioral Healthcare system).

Taken together, these studies represent various points of consideration that have the potential to shape future policies and procedures for building/adapting large health care systems (i.e., fiscal considerations, coordinating with state government initiatives, global mental health).

Learning Objectives:

At the end of the session, the learner will be able to:
  • Discuss the importance of incorporating community partner voices into conversations about financing strategies for evidence-based treatments.
  • Describe the impact of a fiscal mapping process on the financial sustainability of evidence-based youth mental health treatment programs.
  • Describe some benefits of shared ontologies for engineering large healthcare service systems.
  • Discuss practicality and usability perspectives from staff for implementing a statewide electronic case management system.
  • Discuss ethical considerations for furthering global health partnerships, while remaining committed to equity and sustainability.