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Book ; Collection: Best practices in the behavioral management of health from preconception to adolescence

Trafton, Jodie A.

2008

Author's details	ed. by Jodie A. Trafton
Keywords	Chronic Disease / therapy ; Behavioral Medicine
Language	English
Dates of publication	2008-9999
Publisher	Inst. for Brain Potential
Publishing place	Los Altos, CA
Publishing country	United States
Document type	Book ; Collection (display volumes)
New title	Bd. 1 - 2 u.d.T. Best practices in the behavioral management of chronic disease
HBZ-ID	HT015471239
Database	Catalogue ZB MED Medicine, Health

Book: Best practices in the behavioral management of health from preconception to adolescence / 3

Trafton, Jodie A.

2008

Author's details	ed. by Jodie A. Trafton
Collection	Best practices in the behavioral management of health from preconception to adolescence
Language	English
Size	VII, 567 S.
Publisher	Inst. for Brain Potential
Publishing place	Los Altos, CA
Publishing country	United States
Document type	Book
HBZ-ID	HT015473031
ISBN	978-1-932745-46-7 ; 1-932745-46-7
Database	Catalogue ZB MED Medicine, Health

In stock of ZB MED Cologne/Königswinter

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2008 A 1899	order for loan	Magazin

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Book ; Collection: Best practices in the behavioral management of chronic disease

Trafton, Jodie A.

2007

Author's details	ed. by Jodie A. Trafton
Keywords	Chronic Disease / therapy ; Behavioral Medicine
Language	English
Dates of publication	2007-9999
Publisher	Inst. for Brain Potential
Publishing place	Los Altos, CA
Publishing country	United States
Document type	Book ; Collection (display volumes)
New title	Bd. 3 u.d.T. Best practices in the behavioral management of health from preconception to adolescence
HBZ-ID	HT015403926
Database	Catalogue ZB MED Medicine, Health

Book: Best practices in the behavioral management of chronic disease / 2

Trafton, Jodie A.

2007

Author's details	ed. by Jodie A. Trafton
Collection	Best practices in the behavioral management of chronic disease
Language	English
Size	VIII, 434, I-16 S. : graph. Darst.
Publisher	Inst. for Brain Potential
Publishing place	Los Altos, CA
Publishing country	United States
Document type	Book
HBZ-ID	HT015403940
ISBN	978-1-932745-32-0 ; 1-932745-32-7
Database	Catalogue ZB MED Medicine, Health

In stock of ZB MED Cologne/Königswinter

Shelf mark	Loan status	Location
2008 A 1898	order for loan	Magazin

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Book: Best practices in the behavioral management of chronic disease / 1

Trafton, Jodie A.

2007

Author's details	ed. by Jodie A. Trafton
Collection	Best practices in the behavioral management of chronic disease
Language	English
Size	VII, 473, I-16 S. : graph. Darst.
Publisher	Inst. for Brain Potential
Publishing place	Los Altos, CA
Publishing country	United States
Document type	Book
HBZ-ID	HT015403936
ISBN	978-1-932745-15-3 ; 1-932745-15-7
Database	Catalogue ZB MED Medicine, Health

In stock of ZB MED Cologne/Königswinter

Shelf mark	Loan status	Location
2008 A 1897	order for loan	Magazin

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Article ; Online: Veterans Health Administration Outpatient Psychiatry Staffing Model: Longitudinal Analysis on Mental Health Performance.

Smith, Clifford / Boden, Matthew / Trafton, Jodie

Journal of general internal medicine

2023 Volume 38, Issue Suppl 3, Page(s) 814–820

Abstract: Background: An adequate supply of mental health (MH) professionals is necessary to provide timely access to MH services. Veterans Health Administration (VHA) continues to prioritize the expansion of the MH workforce to meet increasing demand for ... ...

Abstract	Background: An adequate supply of mental health (MH) professionals is necessary to provide timely access to MH services. Veterans Health Administration (VHA) continues to prioritize the expansion of the MH workforce to meet increasing demand for services. Objective: Validated staffing models are essential to ensure timely access to care, to plan for future demand, to ensure delivery of high-quality care, and to balance the demands of fiscal responsibility and strategic priorities. Design: Longitudinal retrospective cohort of VHA outpatient psychiatry, fiscal years 2016-2021. Participants: Outpatient VHA psychiatrists. Main measures: Quarterly outpatient staff-to-patient ratios (SPRs), defined as the number of full-time equivalent clinically assigned providers per 1000 veterans receiving outpatient MH care, were calculated. Longitudinal recursive partitioning models were created to identify optimal cut-offs for the outpatient psychiatry SPR associated with success on VHA's measures of quality, access, and satisfaction. Key results: Among outpatient psychiatry staff, the root node identified an outpatient SPR of 1.09 for overall performance (p < 0.001). For metrics associated with Population Coverage, a root node identified an SPR of 1.36 (p < 0.001). Metrics associated with continuity of care and satisfaction were associated with a root node of 1.10 and 1.07 (p < 0.001), respectively. In all analyses, the lowest SPRs were associated with the lowest group performance on VHA MH metrics of interest. Conclusions: Establishing validated staffing models associated with high-quality MH care is critical given the national psychiatry shortage and increasing demand for services. Analyses support VHA's current recommended minimum outpatient psychiatry-specific SPR of 1.22 as a reasonable target to provide high-quality care, access, and satisfaction.
MeSH term(s)	United States/epidemiology ; Humans ; Outpatients ; Veterans Health ; United States Department of Veterans Affairs ; Mental Health ; Retrospective Studies ; Veterans ; Psychiatry ; Workforce
Language	English
Publishing date	2023-06-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	639008-0
ISSN	1525-1497 ; 0884-8734
ISSN (online)	1525-1497
ISSN	0884-8734
DOI	10.1007/s11606-023-08119-1
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: In the balance: No new diagnosis needed in addition to opioid use disorder to study harms associated with long-term opioid therapy.

Drexler, Karen / Edens, Ellen L / Trafton, Jodie A / Compton, Wilson M

Addiction (Abingdon, England)

2023 Volume 119, Issue 1, Page(s) 6–8

MeSH term(s)	Humans ; Analgesics, Opioid/adverse effects ; Opioid-Related Disorders/drug therapy ; Buprenorphine/adverse effects ; Opiate Substitution Treatment
Chemical Substances	Analgesics, Opioid ; Buprenorphine (40D3SCR4GZ)
Language	English
Publishing date	2023-09-27
Publishing country	England
Document type	Editorial
ZDB-ID	1141051-6
ISSN	1360-0443 ; 0965-2140
ISSN (online)	1360-0443
ISSN	0965-2140
DOI	10.1111/add.16349
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Mental health treatment and the role of tele-mental health at the veterans health administration during the COVID-19 pandemic.

Zhang, Jonathan / Boden, Matt / Trafton, Jodie

Psychological services

2021 Volume 19, Issue 2, Page(s) 375–385

Abstract: To quantify overall trends in patients treated for mental health disorders and adverse events, including via tele-mental health (TMH) and psychopharmacology during pandemic-related health care transformation. Longitudinal observational study including ... ...

Abstract	To quantify overall trends in patients treated for mental health disorders and adverse events, including via tele-mental health (TMH) and psychopharmacology during pandemic-related health care transformation. Longitudinal observational study including veterans receiving mental health treatment at a Veterans Health Administration (VHA) facility from January 1, 2017 to June 16, 2020. Observed and expected patient care for on-going and new treatment of depression, posttraumatic stress, substance use disorder, severe mental illness diagnoses, overdose, and suicide attempts, and psychotropic prescriptions for antidepressant, antipsychotic, benzodiazepine, opioid, and mood stabilizing medications are depicted. Percent change between actual and expected counts in the early months of the COVID pandemic (March 18-May 5, 2020) are computed. Decreases in counts of patients receiving mental health treatment early in the pandemic ranged from 7% to 20% for on-going treatment, and 28% to 37% for new treatment. TMH rapidly expanded across VHA, becoming the primary means by which encounters were delivered. Counts of patients receiving on-going care for suicide attempts were stable, and for overdoses, decreased by 17%. Counts of patients initiating care for suicide attempts and overdoses decreased by 30% and 38%, respectively. Weekly prescriptions and medication on-hand for psychotropics ranged from a 2% decrease to a 4% increase. New patient prescribing decreased 21%-50%. VHA and other large healthcare systems will need to expand outreach and continue to develop TMH services to maintain care continuity and initiate care for existing and new patients during COVID-19 and future large-scale outbreaks, epidemics, and disasters. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
MeSH term(s)	COVID-19 ; Drug Overdose ; Humans ; Mental Health ; Pandemics ; United States/epidemiology ; United States Department of Veterans Affairs ; Veterans ; Veterans Health
Language	English
Publishing date	2021-04-08
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	2156662-8
ISSN	1939-148X ; 1541-1559
ISSN (online)	1939-148X
ISSN	1541-1559
DOI	10.1037/ser0000530
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Outpatient provider staffing ratios: Binary recursive models associated with quality, access, and satisfaction.

Smith, Clifford A / Boden, Matthew Tyler / Trafton, Jodie A

Psychological services

2021 Volume 20, Issue 1, Page(s) 137–143

Abstract: Veterans Health Administration (VHA) continues to expand the mental health (MH) workforce to meet increasing demand for services. In the present study, longitudinal unbiased recursive partitioning models (conditional inference trees) were created to ... ...

Abstract	Veterans Health Administration (VHA) continues to expand the mental health (MH) workforce to meet increasing demand for services. In the present study, longitudinal unbiased recursive partitioning models (conditional inference trees) were created to identify optimal cutoffs for outpatient staffing ratios associated with success on VHA's measures of quality, access, and satisfaction. Quarterly Staff-to-Patient Ratios (SPRs), defined as the number of full-time equivalent providers per 1,000 veterans receiving outpatient mental health care, were calculated for 12 quarters from fiscal years 2016-2018. Associations between VHA metrics associated with quality, access, and satisfaction were evaluated in relation to the overall outpatient SPR. The root node identified an overall outpatient SPR of 7.39 as the split for optimal MH performance. Root nodes associated with metrics addressing population coverage, continuity of care, and experience of care identified SPRs of 7.87, 6.81, and 7.42, respectively. In all analyses, the lowest SPRs were associated with the lowest performance on VHA MH metrics, while the highest SPRs were associated with the highest performance. Analyses support VHA's current recommended minimum outpatient SPR of 7.72 as a reasonable target to provide high-quality care, access, and satisfaction. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
MeSH term(s)	United States ; Humans ; Outpatients ; United States Department of Veterans Affairs ; Veterans ; Personal Satisfaction ; Workforce
Language	English
Publishing date	2021-11-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2156662-8
ISSN	1939-148X ; 1541-1559
ISSN (online)	1939-148X
ISSN	1541-1559
DOI	10.1037/ser0000449
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Investigation of population-based mental health staffing and efficiency-based mental health productivity using an information-theoretic approach.

Boden, Matt / Smith, Clifford A / Trafton, Jodie A

PloS one

2021 Volume 16, Issue 8, Page(s) e0256268

Abstract: Background: Healthcare systems monitor and improve mental health treatment quality, access, continuity and satisfaction through use of population-based and efficiency-based staffing models, the former focused on staffing ratios and the latter, staff ... ...

Abstract	Background: Healthcare systems monitor and improve mental health treatment quality, access, continuity and satisfaction through use of population-based and efficiency-based staffing models, the former focused on staffing ratios and the latter, staff productivity. Preliminary evidence suggests that both high staffing ratios and moderate-to-high staff productivity are important for ensuring a full continuum of mental health services to indicated populations. Methods & findings: With an information-theoretic approach, we conducted a longitudinal investigation of mental health staffing, productivity and treatment at the largest integrated healthcare system in American, the Veterans Health Administration (VHA). VHA facilities (N = 140) served as the unit of measure, with mental health treatment quality, access, continuity and satisfaction predicted by facility staffing and productivity in longitudinal mixed models. An information-theoretic approach: (a) entails the development of a comprehensive set of plausible models that are fit, ranked and weighted to quantitatively assess the relative support for each, and (b) accounts for model uncertainty while identifying best-fit model(s) that include important and exclude unimportant explanatory variables. In best-fit models, higher staffing was the strongest and most consistent predictor of better treatment quality, access, continuity and satisfaction. Higher staff productivity was often, but not always associated with better treatment quality, access, continuity and satisfaction. Results were further nuanced by differential prediction of treatment by between- and within-facility predictor effects and variable interactions. Conclusions: A population-based mental health staffing ratio and an efficiency-based productivity value are important longitudinal predictors of mental health treatment quality, access, continuity and satisfaction. Our longitudinal design and use of mixed regression models and an information-theoretic approach addresses multiple limitations of prior studies and strengthen our results. Results are discussed in terms of the provision of mental health treatment by healthcare systems, and analytical modeling of treatment quality, access, continuity and satisfaction.
MeSH term(s)	Efficiency ; Health Personnel/organization & administration ; Health Services Accessibility/organization & administration ; Humans ; Longitudinal Studies ; Mental Health ; Mental Health Services/organization & administration ; Models, Organizational ; Regression Analysis ; United States ; United States Department of Veterans Affairs ; Workforce/organization & administration
Language	English
Publishing date	2021-08-16
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0256268
Database	MEDical Literature Analysis and Retrieval System OnLINE

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