Sustainability in primary care and Mental Health Integration projects in Veterans Health Administration.

Ford JH, Krahn D, Oliver KA, Kirchner J. Sustainability in primary care and Mental Health Integration projects in Veterans Health Administration. Quality management in health care. 2012 Oct 1; 21(4):240-51.

Related HSR&D Project(s)

• RRP 09-161 – Measuring and Improving Sustainability in Mental Health System Redesign

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Abstract:

OBJECTIVE: To explore staff perceptions about sustainability, commitment to change, participation in change process, and information received about the change project within the Veterans Administration Primary Care and Mental Health Integration (PC-MHI) initiative and to examine differences from the Veterans Health Administration Mental Health Systems Redesign (MHSR) initiative. DATA SOURCES: Surveys of change team members involved in the Veterans Affairs PC-MHI and MHSR initiatives. STUDY DESIGN: One-way analysis of variance examined the relationship between commitment, participation and information, and sustainability. Differences in PC-MHI sustainability were explored by location and job classification. Staff sustainability perceptions were compared with MHSR results. PRINCIPAL FINDINGS: Sustainability differed by staff discipline. Difference between MHSR and PC-MHI existed by job function and perceptions about the change benefits. Participation in the change process and information received about the change process were positively correlated with sustainability. Staff commitment to change was positively associated with staff perceptions about the benefits of change and staff attitudes toward change. CONCLUSIONS: Sustainability is an important part of organizational change efforts. Change complexity seems to influence perception about sustainability and impacts staff perceptions about the benefits of change. These perceptions seem to be driven by the information received and opportunities to participate in the change process. Further research is needed to understand how information and participation influence sustainability and affect employee commitment to change.