micro and macro systems in action

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?

For More Information:Karen Zgoda,

karen@karenzgoda.orgLynn Curran, lcurran@partners.org