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Table 2 Convergence and divergence in referral procedures for Site Alpha

From: Between and within-site variation in qualitative implementation research

Redundant concept Convergence or divergence Supporting data
Psychologists are co-located in primary care Convergence MHL: Multiple revisions to service agreements were needed to tailor the implementation to primary care needs.
Divergence PCP: PC/MHI could be expanded to help manage difficult medical patients.
Traditional consultation-liaison service Convergence MHL: PC/MHI supplements the consultation-liaison (POD) services.
Convergence PCMH: POD services are separate from the implementation.
Divergence PCMH: POD restricts access to specialty mental health.
Divergence PCP: POD availability has improved since the implementation, but POD sometimes refers patients back to PC without treatment.
Implementation limited by a lack of space Convergence PCMH: Reported a growth in referrals since implementation and implemented innovative new procedures to make use of limited co-located staffing.
Convergence PCP: Acknowledged improved access, but doubted long-term impact due to lack of space.
  1. Note: Supporting data are presented as either convergent or divergent with the redundant concept. MHL refers to the mental health leader at the site; PCMH refers to the Primary Care/Mental Health Integration (PC/MHI) informants at the site; PCP refers to the primary care physician informants at the site. POD = psychiatrist on duty.