TEAMSS Package Key Drivers

Key drivers are broad, evidence-based and best-practice actions that can be useful in the development of more specific ideas for changes that lead to improvement and are paired with interventions.

Interventions are specific ideas for changing a process; they can be rapidly tested on a small scale to determine whether they result in improvements in a particular context or environment. To support making changes, evidence or practice-based tools and resources were paired with the intervention(s).

1. Improved screening and identification of patients using evidence-based tools

Interventions

Determine office flow for screening by establishing roles and responsibilities of care team
Design practice specific screening with validated tools
Complete training of staff and providers using screening tools
Develop pre visit planning tools to screen prior for well visits
Develop a process for patients not pre-screened or those seen virtually
Incorporate patient and parent viewpoint into screening process

2. Reliable processes and protocols for management of positive screens

Interventions

Identify provider education resources to increase knowledge and confidence
Implement standardization of stepped response to positive screens
Develop a crisis management plan with a stepped protocol for positive screens
Standardize initial medication management of anxiety and depression
- Create scripts for brief interventions

3. Effective follow-up and re-screening

Interventions

Develop resources for practice intervention (brief)
Establish relationships with community-based organizations (schools, churches, sports)
Develop and standardize follow up and rescreening processes
Develop process for rescreening positive screens
Establish monthly reports in clinic workflow for positive screens
Develop a network of care providers for referral and management

4. Partnerships with patients, parents, and community-based resources for management and treatment.

5. Use of data management and population health strategies to manage patients

Interventions

Use data collection/EMR reports to monitor practice implementation and improvement
Document workflows, protocols and job descriptions
Assign roles and responsibilities for staff/clinicians to manage patients with positive screens for substance use, depression, anxiety and suicide risk
Consider using population management tools to evaluate the care of patients not seen for well visits or no shows

6. Active participation in a peer-to-peer learning network with transparent data display and analysis.

Interventions

Attend 4 virtual learning sessions and 2 coaching calls
Conduct tests of change to address implementation of evidence-based guidelines for management of substance use, depression, anxiety and suicide risk
Share best practices, tools, methods and approaches across the learning network
Review data monthly among practice improvement team and staff to drive improvement

TEAMSS Package Key Drivers

Interventions

Interventions

Interventions

Interventions

Interventions

Interventions

Key Driver Diagram

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