Improving Patient Access Through Project ECHO

Problem: Access to psychiatric care is limited across the Intermountain West with less than half of the number of psychiatric providers needed to meet the needs of the population. The purpose of this Quality Improvement (QI) project was to increase access to psychiatric care in a regional hospital in southwestern Wyoming by implementing Project: Extension for Community Healthcare Outcomes (ECHO) education and training. Methods: The project assessed providers level of knowledge and usage of Project ECHO (PE), as well as comfort level and frequency treating adult and pediatric psychiatric patients with a survey. Providers were then educated on the specific offerings of PE and aided in enrollment. A post survey was administered measuring PE use, self-reported Likert-style ratings of comfort level and frequency treating psychiatric patients, free form recommendations for improvement, and barriers encountered. Results: The three-month baseline period showed that of the nine providers that participated one provider increased their use of PE services by 50% and another increased their use by 30%. The providers that did not increase their use of PE (n=7, 78%) had no change in their level of comfort providing psychiatric care while one that increased their use had a decreased comfort level possibly as a result of increased awareness of knowledge deficit. Conclusion: PE has been introduced to this hospital and its providers that have minimal training in psychiatry. The groundwork for change has been initiated. A program for delivering psychiatric services by PE was developed. Further QI cycles are needed to address the barriers to using PE.