Quality improvement and models of behavioral healthcare integration: Position paper #2 from the International Society of Psychiatric-Mental Health Nurses.

This is the second article in a series written to present and address the position of the International Society of Psychiatric-Mental Health Nurses (ISPN) related to the notion of behavioral healthcare integration and the role of nurses in the 21st century. The first article addressed assumptions, definitions and roles related to the integration of behavioral healthcare. The purpose of this article is to focus on Integrated Care within the context of recent initiatives that endeavor to improve quality, safety and reduce costs in the US healthcare system also known as the "Triple Aim" (or more recently, the Quadruple Aim). This paper specifically focuses on the role of nurses and nursing practice by: (a) connecting the concept of integrated behavioral healthcare to quality improvement (QI) and the Quadruple Aim, and (b) highlighting examples of models of integration currently in use. Discussion of models of integration compares ways various models reinforce and actualize integration of behavioral health within primary care, in various special populations across the continuum of care, and in both inpatient and community settings. This paper also stresses innovative training programs offering nurses the skills for learning behavioral health integration through online modules and participation in Interprofessional Education (IPE) activities often through simulation approaches. This 2nd manuscript is consistent with the ISPN 2016 Position Paper and reinforces the necessity for all nurses to be educated on both the Quadruple Aim and behavioral health integration to improve patient care and subsequent care outcomes.