3 - (SYM 150) Engineering Statewide Service System Architectures Through Shared Ontologies: Synergistic Quality Improvement Strategies

Dissemination and implementation (D&I) have been rightfully prioritized as an essential component of improving the quality of clinical intervention. However, D&I efforts have faced numerous barriers at multiple levels, including individual knowledge and attitudes, organizational culture and procedure, and the broader difficulty of translating an expanding evidence base to effective action. These barriers contribute to an estimated 17-year gap on average between the identification and development of evidence-based practices and their broader implementation. One means to potentially address this gap between knowledge and action is through intentional development of shared ontologies in behavioral science (National Academy of Sciences, Engineering, & Medicine, 2022). Formalizing ontologies that structure and describe youth mental health concepts consistently across systems might accelerate both the implementation of current research and the subsequent development of new knowledge. Numerous efforts have been underway in the state of Hawai'i’s youth mental health service system, which shares an ontological framework of treatment targeting, practice elements, and progress ratings across multiple domains (cf. Chorpita, Daleiden, & Weisz, 2005), yielding quality improvement initiatives that would otherwise not be possible. These efforts have included: (1) the creation of electronic health record systems in two of our state’s largest child service divisions, the Department of Education (DOE) and Department of Health (DOH), that share documentation ontologies; (2) community-based academic research examining practices, targets, and progress in public health systems with diverse youth and families (e.g., Wilkie & Mueller, 2021); (3) shared training resources between several sectors of state government rooted in practice element metrics (e.g., Managing and Adapting Practice (MAP); McLennan, Laba, & Nakamura, 2022); (4) dissemination of a wide array of practice-based research findings that predict treatment progress at aggregate levels in our local communities, (5) measurement-based care efforts (Milette-Winfree et al., 2019), and (6) consumer empowerment resources and information centered on the practice element metric (Friedberg et al., 2018). These and other initiatives, as well as implementation and outcome data, will be discussed within the broader context of the benefits that a shared statewide ontological framework can provide to D&I efforts and youth mental healthcare effectiveness research.