Implementing CommonGround in a Community Mental Health Center: Lessons in a Computerized Decision Support System

• Published in: Psychiatric rehabilitation journal 2018-09, Vol.41 (3), p.216-223
• Main Authors: Bonfils, Kelsey A., Dreison, Kimberly C., Luther, Lauren, Fukui, Sadaaki, Dempsey, Abigail E., Rapp, Charles A., Salyers, Michelle P.
• Format: Article
• Language: English
• Subjects: Client Centered Therapy; Community health care; Community Mental Health Centers; Community Mental Health Services - methods; Content analysis; Decision Making; Decision Support Systems; Decision Support Techniques; Employee Turnover; Human; Humans; Intervention; Mental Disorders; Mental health care; Mental institutions; Peer Group; Peers; Program Development; Program Evaluation; Psychiatry; Serious Mental Illness; Teams; Test Construction
• ISSN: 1095-158X; 1559-3126
• DOI: 10.1037/prj0000225

Objective: Although shared decision making (SDM) is a key element of client-centered care, it has not been widely adopted. Accordingly, interventions have been developed to promote SDM. The aim of this study was to explore the implementation process of one SDM intervention, CommonGround, which utilizes peer specialists and a computerized decision support center to promote SDM. Method: As part of a larger study, CommonGround was implemented in 4 treatment teams in a community mental health center. The implementation process was examined by conducting semistructured interviews with 12 staff members that were integral to the CommonGround implementation. Responses were analyzed using content analysis. Program fidelity and client program use were also examined. Results: Although key informants identified several client and staff benefits to using CommonGround, including improved treatment engagement and availability of peer specialists, most clients did not use CommonGround consistently throughout the implementation. Key informants and fidelity reports indicated a number of program (e.g., technological difficulties, increased staff burden) and contextual barriers (e.g., poor fit with service structure, decision support center location, low staff investment and high turnover) to the successful implementation of CommonGround. Strategies to maximize the implementation by increasing awareness, buy-in, and utilization are also reported. Conclusions and Implications for Practice: This implementation of CommonGround was limited in its success partly as a result of program and contextual barriers. Future implementations may benefit from incorporating the strategies identified to maximize implementation in order to obtain the full program benefits.