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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
Microsystem in ActionThe Edward and Gretchen Fish Center for
Women’s Health
Brigham and Women’s HospitalHarvard Medical School
14,000 patients 13 specialties >30 providers, residents 1 full-time social worker 1 part-time social worker Limited additional part-time help
Our Clinic
Tailoring services Provider: patient ratio Varying provider styles and expertise Medically complex patients Little support for mental health
services
Our Challenges
Self definition Interdisciplinary team work Effective communication Boundaries Education
The 5 Essentials for Integrating Mental Health
Services in Medical Practice
• Optimizing Communication: Within team, clinic Complimenting expertise Clear expectations, roles Value of repeated interactions, building
trust Team meetings
Small Changes Benefitting Whole Practice
Flexibility Creativity Feedback Extrapolation Iterative process
Helpful Solutions
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
Lessons Learned
Macro System in Action
Charlestown Connects:
Interagency Collaboration in Charlestown, MA
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
Background: Charlestown Connects
Conceptual Model
Importance of grassroots relationship development and management
Charlestown Connects as community connector and mediator
Interdependence for participation, and results: "My success depends on them.”
Main Research Findings
Interpersonal characteristics: Mutual respect for partners Open to change
Collaboration: Needs strong leadership or advocate Communication
Outcomes Increased connections Vested Interest
Connections Between Micro and Macro Practice
Questions?