1854 – Building the foundation of effective community practice in austere times: urban, rural and blended challenges to evidence-based practice sustainability

Abstract

Introduction While evidence-based psychiatric practices (EBPs) are assumed to be more efficient, savings and sustainability are elusive during times of economic instability. This presentation uses two-years of penetration and cost-related data from46 community mental health providers to document EBP penetration and sustainability during a period of serious funding contraction. Objectives This study sought to identify specific elements that contribute to EBP-related savings and sustainability in urban, rural and blended environments. Aims This study identifies critical organizational practices that sustain EBPs during difficult economic times. Methods Using existing claims data on the State of Michigan website, researchers used a stratified regression analysis to identify critical variables contributing to increased use of EBPs and decreased use of high-cost services. Follow-up qualitative data were collected from administrators of high and low penetration organizations to provide insight into within-agency strategies that contribute to EBP implementation and sustainability. Results Findings identify direct and indirect contributors to sustainability and efficiency when implementing evidence-based practices. Direct contributors include unit-cost funding and the number of EBPs implemented. Indirect contributors include organizational promotion activities that create an atmosphere of excellence. Findings vary across urban, rural and blended environments. Conclusions Evidence-based practices require a strong organizational commitment to remain viable during difficult financial times.