Micro and Macro Systems in Action


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What’s in it For Me?
Lessons Learned from Macro and Micro Systems in Action

Many in the public and private health sectors are interested in the efficacy of the "medical home" model. Is this model worthy of the time and the money needed to create needed supporting infrastructure? How does a primary care clinic integrate mental health services effectively? Public service agencies are also looking for ways to streamline and integrate care more efficiently. Are there parallel practices on the micro and macro levels that can serve as “lessons learned?” What are the benefits and outcomes of such collaborations? What does this look like over the long-term?

This presentation discusses the facilitation of interagency collaboration among non-profit and government agencies on the macro level, which parallels interdisciplinary collaboration among primary care physicians and mental health clinicians on the micro level. Such efforts could streamline service delivery, leading to financially successful agencies while also addressing social problems.

Panel members
1. Karen Zgoda, Boston College & EditMyManuscript.com
2. Lynn Curran, Brigham & Woman’s Hospital

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  • Building community handshake by handshake, conversation by conversation Refer to findings outline
  • Refer to findings outline
  • Micro and Macro Systems in Action

    1. 1. What’s in It For Me?Lessons Learned from Micro and Macro Systems in Action Karen Zgoda, Doctoral Student, Boston College, MA Lynn Curran, LICSW, Brigham & Women’s Hospital, Boston, MA
    2. 2. Microsystem in ActionThe Edward and Gretchen Fish Center for Women’s Health Brigham and Women’s Hospital Harvard Medical School
    3. 3. Our Clinic∗ 14,000 patients∗ 13 specialties∗ >30 providers, residents∗ 1 full-time social worker∗ 1 part-time social worker∗ Limited additional part-time help
    4. 4. Our Challenges∗ Tailoring services∗ Provider: patient ratio∗ Varying provider styles and expertise∗ Medically complex patients∗ Little support for mental health services
    5. 5. The 5 Essentials for Integrating Mental Health Services in Medical Practice ∗ Self definition ∗ Interdisciplinary team work ∗ Effective communication ∗ Boundaries ∗ Education
    6. 6. Small Changes Benefitting Whole Practice• Optimizing Communication: ∗ Within team, clinic ∗ Complimenting expertise ∗ Clear expectations, roles ∗ Value of repeated interactions, building trust ∗ Team meetings
    7. 7. Helpful Solutions∗ Flexibility∗ Creativity∗ Feedback∗ Extrapolation∗ Iterative process
    8. 8. Lessons Learned∗ Staff needs to be open to change in order for growth to happen∗ Reciprocal respect and appreciation for distinct disciplines∗ Focus on collaboration rather that isolation∗ Use technology to facilitate communication (text pages, email, shared medical record/notes)∗ Co-location. Open the door when you can
    9. 9. Macro System in Action Charlestown Connects:Interagency Collaboration in Charlestown, MA
    10. 10. Background: Charlestown Connects∗ Interagency collaboration between public and private programs in Charlestown∗ Aimed to improve the quality of life for Charlestown residents via multi-stakeholder collaboration∗ Created community meetings: ∗ BSMART meetings for community agencies ∗ Neighborhood Response Teams (NRT) for residents and agencies
    11. 11. Conceptual Model
    12. 12. Main Research Findings∗ Importance of grassroots relationship development and management∗ Charlestown Connects as community connector and mediator∗ Interdependence for participation, and results: ∗ "My success depends on them.”
    13. 13. Connections Between Micro and Macro Practice∗ Interpersonal characteristics: ∗ Mutual respect for partners ∗ Open to change∗ Collaboration: ∗ Needs strong leadership or advocate ∗ Communication∗ Outcomes ∗ Increased connections ∗ Vested Interest
    14. 14. Questions?
    15. 15. For More Information:Karen Zgoda, karen@karenzgoda.org Lynn Curran, lcurran@partners.org