Promoting Behavioral Health Integration in Pediatric Primary Care Practices Using a Quality Improvement Project

Abstract

Objective: Pediatric primary care providers are increasingly asked to care for their patients’ behavioral health needs, but few models of behavioral health integration emphasize practical strategies that are widely applicable to practices regardless of resources or size. A pilot cohort of pediatric primary care practices participated in a regional quality improvement (QI) project focused on improving each practice’s levels of behavioral health integration using the Comprehensive Healthcare Integration (CHI) Framework (National Council for Mental Wellbeing, 2022) as a guiding framework. Method: Five practices joined the 10-month QI project pilot cohort. Each practice chose one subdomain from the CHI Framework’s Multidisciplinary Teamwork domain as their project’s focus. Participants attended monthly meetings and educational sessions, completed QI deliverables while implementing their identified interventions, and completed surveys and interviews pre- and post-project. Results: Four of the five practices (80%) reported increasing their behavioral health integration by at least one level on a subdomain of Multidisciplinary Teamwork CHI Framework domain. All practices (100%) reported increased satisfaction with their practice’s level of behavioral health integration, with an average 60% increase from pre- to post-project. Conclusions: Practices made notable improvements to their behavioral health integration during the project. The CHI Framework was useful in structuring practices’ behavioral health goals and assessing improvements. Elements of the QI project process, such as having access to content experts, the cohort format, and accountability provided by the project, appeared valuable to participants. Insights are shared for organizations aiming to support pediatric primary care providers in their behavioral health integration efforts.

Implications for Impact Statement

Five pediatric primary care practices made notable improvements to how they integrate behavioral health concepts into their work during their participation in a new quality improvement project. Supportive efforts like this project could help pediatric primary care practices make positive changes so they can better care for their patients’ behavioral health needs within the primary care setting.