Table 2 Factors influencing Collaborative Chronic Care Model (CCM) sustainability, identified under the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) domains of Innovation, Recipients, Context, and Facilitation

Innovation

• CCM associated with reduced mental health hospitalization

• CCM provided with staffing/funding support

• CCM's fit with existing values of care team members

• Clarity/Knowledge of what CCM entails

• Incorporation of staff feedback in redesigning care to be CCM-consistent

• Relative advantage over alternative ways of approaching general mental health care

Recipients

• Collaborativeness/Teamwork

• Comfortable communication and psychological safety

• Interdisciplinary coordination

• Staff buy-in to CCM-consistent care

• Staff/Leadership turnover

• Uniformity in how CCM team members approach care-related tasks and/or are skilled

Context

• Virtual teamwork and care delivery (COVID)

• Continuation of patient-facing activities (COVID)

• Adequate clinic space for CCM team

• Overall high workload across clinics

• Resources/Capacity for care delivery

• CCM team members subject to significant administrative burden

• More discussion-based collaboration (rather than relying on consults)

• Other clinics welcome receiving team’s patients when deemed clinically appropriate by the team

Facilitation

• CCM team members who were not present for the implementation trial are aware of the facilitation

• Knowledgeable and available external facilitator

• Consistent and strong internal facilitator

• Continued internally facilitated CCM team meetings/huddles

• Having a designated local champion working for culture change