Scientific Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic significantly impacted mental health, resulting in an unprecedented increase in requests for mental health services. To address access challenges, the Massachusetts General Hospital (MGH) Department of Psychiatry developed and implemented the Team-based Outpatient Psychiatry (TOP) Program in July 2020. The program aimed to ensure timely access to mental health services at MGH. Referring providers viewed the program favorably; however, clinical, administrative, and staffing challenges were present. Consequently, program redevelopment was pursued.

Methods: Program redevelopment efforts for the TOP Program were conceptualized through provider feedback, review of current workflows, and planning meetings with program staff. These efforts have been reviewed by the TOP Planning Committee and have occurred in concert with the larger departmental redesign efforts spearheaded by the Outpatient Psychiatry Department Access Team.

Results: Program redevelopment efforts began in November 2022. Departmental leadership identified a team lead with protected administrative time to spearhead the program redevelopment effort. Identified aims included 1. Re-conceptualize the program; 2. Establish standardized operating procedures; 3. Problem solve program challenges; 4. Expand clinical services; and 5. Implement program evaluation. Aims 1-3 have been classified as short- to intermediate-term and are currently underway with a deadline of July 2023. Aims 1-3 include developing a mission statement, refining the model, creating a standardized operating procedure manual, developing standardized Epic-based documentation, recreating clinical templates to ensure sustainability for staff, and hiring new staff for unfilled roles. Aims 4-5 have been classified as long-term and will be initiated after implementation of aims 1-3 with a potential timeline of December 2023.

Conclusions: This program redevelopment effort has identified multiple areas for improvement within the TOP Program. Together, these efforts will help to address challenges in ensuring accessible, timely, and evidence-based services at MGH.