Collaborative Care: Exploration of a Transdisciplinary Model at a Community Based Health Center

Patricia Bruner

doi:10.17918/etd-3356

Racial and ethnic minorities represent a growing portion of the population (United States Census Bureau, 2004) and tend to experience worse health and mental health outcomes as compared to White populations (United States Department of Health and Human Services, n.d.). Since ethnic and racial minority populations tend to first seek mental health services through their primary care providers, more research is needed to explore how collaborative care between medical and mental health providers in primary health care settings can improve patient outcomes. The goal of this longitudinal mixed-method study was to investigate collaboration among this transdisciplinary health care team at The Eleventh Street Family Health Services exploring the following 3 aims: (1) facilitators and barriers to collaboration; (2) how provider and patient characteristics affect the collaborative process; and (3) interdisciplinary collaboration from the perspectives of all members of the healthcare team, exploring the emphasis on family and community involvement in the process. Regarding the first aim, the qualitative data revealed that many factors facilitated the collaborative process including collocation of services, multiple communication systems, and having a shared vision of patient care. Factors that impeded collaboration included poor communication between providers, lack of easy access through schedules and building layout issues, and overall work volume. In terms of the second aim, qualitative results revealed that staff viewed their intense focus on patient care and mutual respect for each other as key aspects of their characteristics as providers. They also recognized that various provider characteristics such as professional role, gender, and age affected collaboration, but there were mixed responses regarding the level of awareness of the impact of their own race and culture. In terms of patient characteristics, staff consistently noted that their patients tended to be underprivileged facing multiple issues such as ethnic and racial minority status, low socioeconomic income, poor health care history, and exposure to trauma and violence. Finally, in terms of the third aim, while the majority of the support staff tended to participate less often in discussions than the professional staff and department leaders and also tended to drop out at time 2 data collection, the support staff still made valuable contributions, highlighting the essential and unique role they played as the first point of contact for patients. The level of family and community involvement was also explored in this study, with participants noting a more patient-centered approach, with only serendipitous family and community involvement which is an area of future growth at the center.

Collaborative Care: Exploration of a Transdisciplinary Model at a Community Based Health Center

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Collaborative Care: Exploration of a Transdisciplinary Model at a Community Based Health Center

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