knproject.org

See CEO Reports (River Edge, MHCD, CSTN, CSIN, CHCS) for individual center updates.

Download Powerpoint Summary from Implementation Work Group Update at May 2011 KN Summit

Download Powerpoint Summary from Implementation Work Group Update at Nov 2010 KN Summit

Goals for Fall 2011:

• Engage with Managed Care
• Increase engagement with SAMHSA
• Create a standardized suicidality definition that can inform each agency's automated alerts
• Hold a Clozapine training for medical staff at KN sites via webinar

Completed and Ongoing Projects:

• Collected Baseline Implementation Information from participating Knowledge Network CMHCs.
• Developed 2 proposed Rapid-Cycle Implementation Plans.
• Submited 1 federal grant proposal to test these plans at Knowledge Network CMHCs.
• Developed Clozapine Implementation Action Plans specific for each center.

Why Implementation?
Even the best research projects fail because organizations do not share best practices about how they were successful. Typically, only the results from research initiatives are made known, but it is clear that some strategies are more successful than others. This group’s goal is to improve adoption of research based interventions in CMHCs.

	“Our biggest challenge is inertia. Organizations and systems are difficult to change. It is easier to continue doing business as usual–even if it is less effective or efficient. Data driven change should be the goal of our behavioral health organizations.” – Angela Smart, MS, Valley Mental Health		“Implementation of research-based practice is so complex.  It is dependent on multiple factors at an agency...including culture and climate at the clinic as well as the leadership level.  In the KN we can learn from each other as we develop best practices for promoting clinician behavior change.” – April Bragg, PhD, Centerstone Research Institute

 Increasing Adoption: The Clozapine Project
 Our chosen Research-Based Intervention that we are focusing on for 2009-2010 is to increase the prescription of the generic medication clozapine for individuals with schizophrenia who screen positive for suicidality or treatment resistance.

Clozapine is one of several groundbreaking research-based practices showing clear benefits to quality of life, length of life, and cost effectiveness of treatment for individuals with schizophrenia. As you can see in this graph [Horvitz-Lennon M, Donohue JM, Domino ME, Normand SL. Health Aff 2009 May-Jun; 28 (3): 701-12] , despite these benefits, currently implementation methods have had 0% impact on the use of clozapine.

The Implementation Working Group has met all three of its tasks for its Spring Summit 2010 deadline. Below is a chart from the submitted grant proposal detailing the phases of the 2 proposed implementation models to increase clozapine adoption.

2009-2010 Implementation Leadership Team
Dr. April Bragg, CRI (facilitator); Kathleen Varda, River Edge Behavioral Health Center; Dr. A. Camis Milam, University of Texas San Antonio; Linda Lopez, Center for Health Care Services; Shawna McGuckin, Mental Health Center of Denver; Drs. Karen Rhea & Brad Nunn, Centerstone Tennessee; Shirley Arney and Dr. Jerry Neff, Centerstone Indiana; Dr. Herbert Meltzer, Vanderbilt University; Dr. Kevin Hennessy, SAMHSA; Dr. Charles Brown, CRI; Don Hevey, MHCA.