Evaluation of Ongoing Crisis Intervention Team (CIT) Training for Law Enforcement Using the ECHO Model.

Crisis Intervention Team (CIT) training aims to improve law enforcement officers' (LEOs) ability to safely intervene in calls for service involving individuals with mental illness, as well as to increase LEOs' ability to link these individuals to mental health services and divert them from the criminal justice system. However, most CIT training is delivered as a stand-alone class, and continuing education in CIT principles and best practices is limited. To address this problem, the Albuquerque Police Department, in partnership with the Department of Psychiatry and Behavioral Sciences at the University of New Mexico, developed CIT ECHO to provide continuing education in CIT best practices. The authors evaluated 113 weekly CIT ECHO sessions targeting LEOs in New Mexico, offered between 2017 and 2020. LEOs electronically completed a post-session survey after each didactic; additionally, a targeted follow-up survey was distributed to LEOs participating in at least three sessions. Surveys measured impact of CIT ECHO on knowledge, self-efficacy, and attitudes towards individuals with mental illness involved in the criminal justice system. After participating in CIT ECHO, LEOs reported increases in knowledge of didactic content and that they felt comfortable applying didactic content on the job. LEOs also evidenced positive attitudinal shifts towards individuals with mental illness and criminal justice involvement. Continuing education in CIT best practices appears to increase LEOs' knowledge base and comfort in working with individuals with mental illness and criminal justice involvement, as well as results in positive attitudinal shifts towards this population.

Implementation Challenges and Recommendations for Employing Peer Support Workers in Emergency Departments to Support Patients Presenting after an Opioid-Related Overdose.

The placement of a peer support workers (PSWs) in emergency departments (ED) is a promising practice for supporting persons with opioid use disorder who are presenting with an overdose or related medical condition. However, this practice is underutilized. The objective of this study was to identify the challenges of employing PSWs in the ED and provide a checklist to increase the likelihood of their successful integration and retention in this environment. Qualitative methods were used to collect data from nineteen key stakeholders who worked in hospital settings. Using a social-ecological model, themes were identified at the system, hospital, and individual levels. To support integration of PSWs and buy in for the ED team, our findings indicate a need for a planning phase that includes collaboration between leadership, ED staff, and PSWs. Specifically, planning should address four areas: (1) hiring a PSW that is a good fit for the fast-paced ED setting, (2) education of ED staff on the value and role of PSWs, (3) establishing workflow protocols, and (4) providing PSWs with training and appropriate supervision.

Beyond crisis intervention team (CIT) classroom training: Videoconference continuing education for law enforcement.

Continuing education in Crisis Intervention Team (CIT) principles and best practices are limited. In 2015, the Albuquerque Police Department became the first law enforcement agency in the country to provide extended learning for CIT and case debriefings related to behavioral health through videoconferencing technology. The project, known as CIT ECHO, connects law enforcement agencies across New Mexico and the country to an online classroom where CIT experts and psychiatrists review behavioral health topics, and debrief complex cases with officers. An overview of CIT ECHO is provided including key elements, implementation challenges, and how we are evaluating its reach and effectiveness.

Evaluating a novel health system intervention for chronic kidney disease care using the RE-AIM framework: Insights after two years.

INTRODUCTION: Using a quasi-experimental design, we implemented the Patient-Centered Medical Home for Kidney Disease (PCMH-KD), a comprehensive, multidisciplinary care team to improve quality of life and healthcare coordination for adult chronic hemodialysis (CHD) patients. This paper highlights our experience in the first two years of the study. We focus on the process dimensions of Reach, Adoption, and Implementation within the context of the RE-AIM framework. MATERIALS AND METHODS: We established a new PCMH-KD model at two outpatient dialysis centers. During the intervention phase, adult patients were recruited for participation and data collection. We monitored RE-AIM measures to identify areas for potential adaptation of the care model. RESULTS: During the start-up phase, we engaged patients and stakeholders in planning the intervention, established the new PCMH-KD team, and trained new and continuing clinicians and staff at two dialysis centers. In the intervention phase we recruited 155 patients to participate. Patients had individual visits with the PCP (40%) and the CHWs (92%) (Reach). Patient feedback informed procedures for appointment scheduling (Adoption). The new PCMH-KD team members were consistent in their roles. With staff changes, some responsibilities were adapted for cross coverage (Implementation). IMPLICATIONS: After one year of start-up and one year of intervention, active monitoring of Reach, Implementation and Adoption measures have facilitated necessary adaptions in the planned intervention to accommodate scheduling demands and patient feedback in the PCMH-KD model. Insights from this trial may inform care of CHD patients more broadly.