Evaluation of Peer Specialists on VA PACTs
Evaluation of Peer Specialists on VA PACTs
In August 2014, the White House issued an Executive Action mandating that 25 VA medical
 centers place Peer Specialists (Veterans recovered from mental illness who are trained to
 support other Veterans with mental illness) on Primary Care Teams. Research shows that the
 success of adding new staff to existing teams can be improved by outside aid and
 facilitation. This quality improvement project will evaluate whether providing expanded
 support to half of the Primary Care Teams will lead to better outcomes when compared with
 teams that do not get extra support.
Peer Specialists are individuals with mental illness currently deployed to serve Veterans in
 specialty mental health clinics based upon their lived experiences. Peer Specialist delivered
 interventions have been shown to improve patient activation in multiple studies. In August
 2014, the White House issued an Executive Action mandating that 25 VA medical centers pilot
 the deployment of Peer Specialists in their Patient Aligned Care Teams (PACTs). This project
 expands upon this nationally mandated Peer Specialist pilot with the integration of a cluster
 randomized implementation trial. This quality improvement project will evaluate the impact of
 facilitated implementation vs. standard implementation to support on the deployment of Peer
 Specialists in PACTs.

 The 25 sites will be divided into three cohorts (n=8,8,9). Each cohort will begin over three
 successive six-month blocks beginning in early 2016. Within each cohort, sites will be
 randomized to receive either facilitated or standard implementation. Facilitated
 Implementation sites will receive one year of support based on the i-PARIHS implementation
 model which includes training, implementation planning, ongoing external facilitation,
 feedback and consultation. Standard Implementation sites will receive written guidance and
 limited consultation by the investigators' team. The investigators will compare the groups on
 1) the percent of their target population that actually received PS services; 2) ratings on
 PS workload productivity including ; 3) Peer Implementation and Services scores; 4)
 assessment of Veteran's change over time on the outcome variables of satisfaction,
 activation, and functioning ; 5) qualitative analysis of how well PSs were deployed and their
 impact.
Inclusion Criteria:

 -  Included sites must be VA PACT Primary Care Health teams with existing Peer
 Specialists who are able to include an existing Peer Specialist on their team for a
 minimum of 10 hours per week for one year

 Exclusion Criteria:

 -  Non VA PACT teams, VA sites without an existing Peer Specialists, and VA PACT primary
 care teams that cannot commit a Peer Specialist to Primary Care for a minimum of 10
 hours per week are excluded