N/A
Completed N=9
Evaluation of Implementing FLOW
Source: ClinicalTrials.gov NCT04193033 ↗Enrolled (actual)
9
Serious AEs
—
Results posted
Aug 2024
Primary outcomePrimary: Reach: Percent of Specialty Mental Health Patients Transitioned to Primary Care — 1.41; .77; 1.89 Percent of mental health patients — p=0.001
Summary
Adequate access to mental health is one of the most important problems facing the VA and VISN 19. Mental health patients who are stabilized and recovered should be transitioned back to primary care to increase availability in mental health for new patients, and to signal to recovered patients that they are successfully recovered. Because there are currently no methods to identify who is recovered or tools and processes to assist in transitions, few patients 'graduate' mental health. The FLOW program consists of an algorithm to identify patients who are potentially appropriate for transition, a user-friendly online report to communicate this information to providers, materials to explain this process to patients and providers, and an electronic medical record (EMR) note template to document the transition. The investigators are partnering with VISN 19 to evaluate this program using a stepped wedge design with 9 sites randomly allocated into 3 steps in the wedge. Sites will receive an evidence-based implementation facilitation approach. The investigators will evaluate the number of patients transitioned, success of those transitions, and patient and provider satisfaction.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Reach: Percent of Specialty Mental Health Patients Transitioned to Primary Care |
1.41; .77; 1.89 | 0.001 sig |
| PRIMARY Effectiveness of Intervention's Impact on Clinic Access |
148.7; 222.33; 354.2 | 0.012 sig |
| PRIMARY Adoption: Percent of Mental Health Providers Who Use FLOW Intervention |
14.24; 8.09; 8.47 | 0.66 |
| PRIMARY Implementation Fidelity to the Protocol |
100; 100; 100 | — |
| SECONDARY Maintenance of Effectiveness of Intervention's Impact on Clinic Access |
171.73; 81.26; 147 | .49 |
| SECONDARY Maintenance of Implementation Fidelity to the Protocol |
100; 100; 100 | — |
| SECONDARY Maintenance of Reach: Percentage of Specialty Mental Health Patients Transitioned to Primary Care |
2.95; 1.08; 2.59 | 0.06 |
Eligibility Criteria
Inclusion Criteria
- This study uses site-level randomization
- Sites must be VA sites with substantial numbers of mental health patients
- VA medical centers or large or very large community based outpatient clinics
Exclusion Criteria
- Non-VA sites and CBOCs smaller than large
Data sourced from ClinicalTrials.gov (NCT04193033). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.