设计一个实施策略,以增加与健康相关的社会需求查:在资源有限的临床环境中应用PRISM框架
Elena Byhoff1, Amy M LeClair2, Cara N Smith3
1Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Translational behavioral medicine
|October 28, 2023
概括
在社区卫生中心 (CHC) 实施与健康相关的社会需求 (HRSN) 查具有挑战性. 具体上下文策略,参与利益相关者,解决工作流程障碍是成功采用HRSN查的关键.
科学领域:
- 实施科学 实施科学
- 医疗保健服务研究 医疗服务研究
- 社区健康 社区健康
背景情况:
- 尽管越来越多的接受和政策支持,但与健康相关的社会需求 (HRSN) 查的临床实施仍然很低.
- 由于资源有限,社区卫生中心 (CHC) 在实施和维持HRSN查方面面临着独特的挑战.
- 对于服务于弱势群体的中医疗保健中心,确定特定环境的实施策略至关重要.
研究的目的:
- 设计一个适合热热中心特定环境的HRSN查实施策略,使用实用稳健实施和可持续性模型 (PRISM).
- 确定在CHC内实施HRSN查的障碍和促进者.
- 根据利益相关者的意见和上下文分析,制定可行的实施策略.
主要方法:
- 雇佣了快速民族学评估的观察和利益相关者的焦点小组,以了解CHC的工作流程.
- 利用PRISM框架指导制定一个与环境相关的实施策略.
- 分析数据以确定与选实施障碍和促进者的相关主题.
主要成果:
- 确定了阻碍HRSN查实施的八个关键主题:耻辱,需要社区解决方案,组织优先事项,电子医疗记录 (EMR) 的限制,多任务压力,员工流动,监管知识差距和资源可用性.
- 制定了有针对性的实施策略,包括非EMR数据收集,工作流集成,新培训模块和同行冠军识别.
- 强调,单独的行政要求不足以成功实施.
结论:
- 环境特定的利益相关者参与对于改善HRSN查在资源有限的环境中如CHCs中的实施成功至关重要.
- 普里斯姆模型有效地将上下文因素纳入实施战略设计中.
- 针对特定障碍的定制策略是必要的,以便在CHC中可持续地进行HRSN查.
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