We’ve always felt that there is too big a gap between the great work that we do at the Bree Collaborative and how care is delivered in Washington State. To help change care delivery we are embarking on a new, and funded, implementation initiative.

Part of this will be focused on integrating behavioral health into primary care through practice transformation and coaching. We aim to assist, supplement, and build up existing behavioral health programs within a primary care clinic, or help start a behavioral health integration effort if none currently exists. To accomplish this, we are recruiting primary care sites to be a part of a pilot group with 1:1 practice coaching, facilitated assessment, monthly webinars or trainings on our recommendations, and we will be convening our community for an implementation summit March 17th, 2020.

We will be focusing on:


For our practice coaching pilot group we will be recruiting 10 primary care sites across the state for 1:1, higher-intensity practice coaching. If you are interested, fill out our survey here by November 8th. You can also find information about this initiative on our flyer here.

We organize our work into four phases:

Phase 1: Engagement

  • – Clinics identified and notified by the end of November.
  • – Initial phone call to discuss internal team development.
  • – Introduction to the behavioral health Bree Collaborative guidelines.


Phase 2: Assessment

  • – Onsite visit with team in January.
  • – Completion of the baseline assessment (MeHAF) facilitated by Bree Collaborative staff with internal team. For each assessment, clinics will receive $500 (up to four times).
  • – Development of customized action plan based on results of assessment that includes three to four projects to work on as a clinic, with assistance where appropriate (usually once a month or every two months depending on availability).  Action plan projects are activities highlighted within the Bree Guidelines recommended as a best practice that are not currently in place in the clinic (e.g., registry; developing or improving a referral process with local behavioral health partner).
  • – Based on conversation during the assessment, will also assess current electronic health record and data capabilities, and identify any immediate training needs.


Phase 3: Improvement

  • – The real work! Develop a course of action with each clinic for each clinic’s action plan: based on specific items do customized quality improvement work (e.g., work flow mapping; Plan-Do-Study-Act cycles; link with appropriate community experts and resources).
  • – Ongoing phone calls and site visits to move action plan work along as needed.
  • – Monthly webinars or trainings.
  • – Continue to do the MeHAF assessment every six months facilitated by Bree Collaborative staff. Write a new or revised action plan after each assessment.
  • – Facilitated connection with peer learning community.


Phase 4: Sustainability

  • – Finalize projects and new processes that developed out of each action plan.
  • – Institutionalize within each clinic.
  • – Help solidify the strong foundational quality improvement work so that it can continue on!


Outside of this higher-intensity practice coaching, we will be supporting practice transformation across the state through regional engagement and virtual trainings. Our staff can’t be everywhere and so we are working to be strategic with limited resources. To support these pilot primary care sites AND our broader community, we will be holding an implementation summit on March 17th in SeaTac. We will also be holding a second summit before the end of the project in 2021, date to be determined.

Let us know how you want to be involved!

Ginny Weir, MPH
Director, Bree Collaborative