Readiness Assessment

The purpose of this assessment was to understand the current readiness of Minnesota CAHs to successfully integrate behavioral health with primary care. The information from the assessment was used to gauge the collective readiness towards integrating behavioral health across the state as well as plan for technical assistance. 

Creation of the Readiness Assessment

The assessment considered two main areas of focus: organizational structure (does the CAH have the leadership infrastructure to support behavioral health integration?) and operational structure (to what extent has behavioral health already been planned for or operationalized?). Items in these two focus areas were used to determine strengths and needs. All items were scored on a four-point system with higher scores indicating higher levels of strength in that area. A third section was included in the assessment to assist in the identification of educational needs.

The organizational structure was determined through the use of the Performance Excellence Framework. This assessment can be used as a systems-based framework for rural hospitals to develop and support critical success factors in key areas leading to performance excellence across the organization.

Key Areas of the Assessment:

  • Leadership
  • Strategic Planning
  • Patients, Partners and Communities
  • Data Collection, Management and Analysis 
  • Workforce and Culture
  • Operations and Processes
  • Impact and Outcomes

For more information on the Performance Excellence Framework and a blueprint for performance excellence in CAHs, read the Critical Access Hospital Blueprint for Performance Excellence.

The operational structure was assessed with items that would help gauge the hospital’s current implementation of a variety of activities that address the population health issue, in this case behavioral health. Items included topics such as the use of depression, anxiety and substance abuse screenings; staff education on behavioral health issues; collaboration with community providers and resources; use of telehealth for this population and the collection of relevant clinical measures.

The current status on topics is measured by Likert scale for responses to assessment questions:

  • Aware = Currently have awareness of this opportunity but has not yet been addressed (1 point)
  • Planning = There is current discussion and planning taking place to implement this opportunity (2 points)
  • Progressing = Implementation of this opportunity is underway (3 points)
  • Sustaining = This opportunity has been implemented and is a regular part of our process or operations (4 points)

Distribution and Use of the Readiness Assessment

All 78 CAHs in Minnesota were invited to attend an educational webinar concerning the assessment. Reminder emails were also sent in an effort to enhance the response rate. The one-hour webinar presented information about the purpose of the assessment, instructions for completing and an announcement concerning the opportunity for hospitals to apply for individualized technical assistance. 

Results of the readiness assessment were used in two ways. First, a report summarizing all responses was created to assist the Minnesota Department of Health in identifying statewide trends, current readiness and future needs regarding this population. Secondly, for those hospitals interested in receiving individualize TA, their responses were used in a scoring and ranking process to identify the hospitals readiest to receive TA.

This project is supported by the Federal Office of Rural Health Policy (FORHP), Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services (HHS) under grant number H54RH00023. The information, conclusions and opinions expressed in this document are those of the authors and no endorsement by FORHP, HRSA or HHS is intended or should be inferred.