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  • Measure Summary
  • NQMC:009914
  • Jan 2016

Assessment of integrated care: overall score on the Site Self Assessment (SSA) Evaluation Tool.

Maine Health Access Foundation (MeHAF). Instructions for completing the Site Self Assessment (SSA) Survey – January 2016 annual update: MeHAF Integrated Care Initiative. Augusta (ME): Maine Health Access Foundation (MeHAF); 2016 Jan 11. 6 p.

View the original measure documentation External Web Site Policy

This is the current release of the measure.

The measure developer reaffirmed the currency of this measure in March 2016.

Primary Measure Domain

Clinical Quality Measures: Structure

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to assess the overall score for the Site Self Assessment (SSA) Evaluation Tool.

Survey respondents are instructed to focus on their site's current extent of integration for patient and family-centered primary care, behavioral and mental health care, using a 1 to 10 scale, where higher scores represent more complex levels of integrated care. The 18 characteristics are divided into two sections and include:

Integrated Services and Patient and Family-Centeredness

  1. Level of integration: primary care and mental/behavioral health care?
  2. Screening and assessment for emotional/behavioral health needs (e.g., stress, depression, anxiety, substance abuse) (Alternate: If you are a behavioral or mental health site, screening and assessment for medical care needs)?
  3. Treatment plan(s) for primary care and behavioral/mental health care
  4. Patient care that is based on (or informed by) best practice evidence for behavioral health (BH)/mental health (MH) and primary care
  5. Patient/family involvement in care plan
  6. Communication with patients about integrated care
  7. Follow-up of assessments, tests, treatment, referrals and other services
  8. Social support (for patients to implement recommend treatment)
  9. Linking to Community Resources

Practice/Organization

  1. Organizational leadership for integrated care
  2. Patient care team for implementing integrated care
  3. Providers' engagement with integrated care ("buy-in")
  4. Continuity of care between primary care and behavioral/mental health
  5. Coordination of referrals and specialists
  6. Data systems/patient records
  7. Patient/family input to integration management
  8. Physician, team and staff education and training for integrated care
  9. Funding sources/resources

Note: Each section of Site Self Assessment (SSA) Evaluation Tool has a possible total of 90 points (for a possible total of 180 points for the overall tool).

Rationale

There is growing knowledge and appreciation for the high prevalence of mental health conditions in the general adult population and, moreover, the impact that this issue is having on the primary care setting. The rationale or purpose to integration is to address the burden of chronic disease in the primary care setting (including depression and other mental health conditions) and the lack of access to mental health and behavioral health services, particularly in rural communities and for low-income or Medicaid-insured populations. Most primary care providers are simply swamped by patients who are either co-morbid with mental health and medical conditions or who have chronic medical conditions and are having trouble changing unhealthy or risky behaviors.

Improving care coordination and delivering integrated services for behavioral health and primary care is a key strategy to promote patient-centered care. Since 2006, Maine Health Access Foundation (MeHAF) has teamed up with an array of partners ranging from provider groups to insurers to patients to promote integrated care. To date, about 50% of all primary care practices in Maine provide some level of integrated behavioral health and primary care.

The Site Self Assessment (SSA) instrument will be used as one method to assess MeHAF sites' progress toward implementing patient/family centered integrated care, as well as to encourage on-site staff to reflect on the changes they have made and further changes needed to deliver all components of integrated care. It is especially designed to stimulate discussion and common understanding among interdisciplinary practice team members about the site's level of integrated care.

Evidence for Rationale

Boober B. (Senior Program Officer, Maine Health Access Foundation, Augusta, ME). Personal communication. 2015 Apr 29.  1 p.

John Snow, Inc. (JSI). Maine Health Access Foundation evaluation of Integration Initiative. Year one report. Boston (MA): John Snow, Inc.; 2009 Dec 30. 37 p.

Maine Health Access Foundation (MeHAF). Instructions for completing the Site Self Assessment (SSA) Survey – January 2016 annual update: MeHAF Integrated Care Initiative. Augusta (ME): Maine Health Access Foundation (MeHAF); 2016 Jan 11. 6 p.

Maine Health Access Foundation. Two new MeHAF grants expand integrated care to more providers across Maine. [internet]. Augusta (ME): Maine Health Access Foundation; 2012 Sep 28 [accessed 2014 Oct 28].

Scheirer MA, Leonard BA, Ronan L, Boober BH. Site self assessment evaluation tool for the Maine Health Access Foundation Integration Initiative. Augusta (ME): Maine Health Access Foundation; 2010 Apr. 11 p. [16 references]

Primary Health Components

Site self-assessment; patient/family-centered integrated care; primary, behavioral, and mental health care; overall score

Denominator Description

This measure applies to sites that completed the Site Self Assessment (SSA) Survey (one site at a time).

Numerator Description

Overall score on the Site Self Assessment (SSA) Survey (see the related "Numerator Inclusions/Exclusions" field)

Type of Evidence Supporting the Criterion of Quality for the Measure

  • One or more research studies published in a National Library of Medicine (NLM) indexed, peer-reviewed journal

Additional Information Supporting Need for the Measure

Unspecified

Extent of Measure Testing

Unspecified

State of Use

Current routine use

Current Use

Care coordination

Internal quality improvement

Monitoring and planning

Measurement Setting

Ambulatory/Office-based Care

Behavioral Health Care

Community Health Care

Emergency Department

Hospital Inpatient

Hospital Outpatient

Patient-centered Medical Homes

Skilled Nursing Facilities/Nursing Homes

Substance Use Treatment Programs/Centers

Transition

Other

Type of Care Coordination

Coordination across provider teams/sites

Coordination between providers and community

Coordination between providers and patient/caregiver

Coordination within a provider team/site

Professionals Involved in Delivery of Health Services

Advanced Practice Nurses

Allied Health Personnel

Clinical Administrators/Managers

Dentists

Nurses

Physician Assistants

Physicians

Psychologists/Non-physician Behavioral Health Clinicians

Social Workers

Least Aggregated Level of Services Delivery Addressed

Clinical Practice or Public Health Sites

Statement of Acceptable Minimum Sample Size

Does not apply to this measure

Target Population Age

Does not apply to this measure

Target Population Gender

Does not apply to this measure

National Quality Strategy Aim

Better Care

National Quality Strategy Priority

Effective Communication and Care Coordination

IOM Care Need

Not within an IOM Care Need

IOM Domain

Not within an IOM Domain

Case Finding Period

Unspecified

Denominator Sampling Frame

Health care or public health organization

Denominator (Index) Event or Characteristic

Health Care/Public Health Organization Characteristic

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
This measure applies to sites that completed the Site Self Assessment (SSA) Survey (one site at a time).

Exclusions
Unspecified

Exclusions/Exceptions

Does not apply to this measure

Numerator Inclusions/Exclusions

Inclusions
Overall score on the Site Self Assessment (SSA) Survey

Note:

  • Survey respondents are instructed to focus on their site's current extent of integration for patient and family-centered primary care, behavioral and mental health care, using a 1 to 10 scale, where higher scores represent more complex levels of integrated care.
  • Each section of the SSA Evaluation Tool has a possible total of 90 points (for a possible total of 180 points for the overall tool).

Exclusions
Unspecified

Numerator Search Strategy

Fixed time period or point in time

Data Source

Health professional survey

Type of Health State

Does not apply to this measure

Instruments Used and/or Associated with the Measure

Site Self Assessment (SSA) Survey

Measure Specifies Disaggregation

Does not apply to this measure

Scoring

Composite/Scale

Interpretation of Score

Desired value is a higher score

Allowance for Patient or Population Factors

Unspecified

Standard of Comparison

Internal time comparison

Original Title

Overall score.

Measure Collection Name

Site Self Assessment (SSA) Survey

Submitter

Maine Health Access Foundation - Nonprofit Organization

Developer

Maine Health Access Foundation - Nonprofit Organization

Funding Source(s)

Maine Health Access Foundation

Composition of the Group that Developed the Measure

Maine Health Access Foundation (MeHAF) staff and contracted consultants with evaluation expertise

Financial Disclosures/Other Potential Conflicts of Interest

None

Adaptation

This measure was adapted from the Assessment of Primary Care Resources and Supports for Chronic Disease Self Management (PCRS) developed by the Robert Wood Johnson Foundation Diabetes Initiative, www.diabetesinitiative.org External Web Site Policy. This measure was also adapted from the Assessment of Chronic Illness Care (ACIC) survey developed by the MacColl Institute for Healthcare Innovation, Group Health Cooperative.

Date of Most Current Version in NQMC

2016 Jan

Measure Maintenance

Unspecified

Date of Next Anticipated Revision

Unspecified

Measure Status

This is the current release of the measure.

The measure developer reaffirmed the currency of this measure in March 2016.

Source(s)

Maine Health Access Foundation (MeHAF). Instructions for completing the Site Self Assessment (SSA) Survey – January 2016 annual update: MeHAF Integrated Care Initiative. Augusta (ME): Maine Health Access Foundation (MeHAF); 2016 Jan 11. 6 p.

Measure Availability

Source available from the Maine Health Access Foundation (MeHAF) Web site External Web Site Policy.

For more information, contact MeHAF at 150 Capitol Street, Suite 4, Augusta, ME 04330; Phone: 207-620-8266; Fax: 207-620-8269; Web site: www.mehaf.org External Web Site Policy.

NQMC Status

This NQMC summary was completed by ECRI Institute on April 9, 2015. The information was verified by the measure developer on April 23, 2015.

The information was reaffirmed by the measure developer on March 16, 2016.

Copyright Statement

No copyright restrictions apply.

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