Evidence-based VA care is best for meeting Veterans' mental health needs, such as depression, PTSD and opioid use disorder, to prevent suicide or overdose. But some key evidence-based practices only reach 3-28% of patients. Participatory system dynamics (PSD) helps improve quality with existing resources, critical in mental health and all VA health care. PSD uses learning simulations to improve staff decisions, showing how goals for quality can best be achieved given local resources and constraints. This study aims to significantly increase the proportion of patients who start and complete evidence-based care, and determine the costs of using PSD for improvement. Empowering frontline staff with PSD simulation encourages safe 'virtual' prototyping of complex changes to scheduling, referrals and staffing, before translating changes to the 'real world.' This study determines if PSD increases Veteran access to the highest quality care, and if PSD better maximizes VA resources when compared against usual trial-and-error approaches to improving quality.
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Proportion of patients initiating and completing a course of evidence-based psychotherapy (EBPsy) or evidence-based pharmacotherapy (EBPharm)
Timeframe: Pre-/Post- 12-month period average of EBP reach (24 months total observation)]
Number of completed EBPsy templates during sessions with a relevant CPT code
Timeframe: Pre-/Post- 12-month period average of EBP reach (24 months total observation)]
Number of combination of prescriptions placed with the VA pharmacy and sessions with a relevant CPT code
Timeframe: Pre-/Post- 12-month period average of EBP reach (24 months total observation)]