通过组织领导和气候改善青年心理健康的基于测量的护理实施:随机试验中的机制分析
Nathaniel J Williams1,2, Mark G Ehrhart3, Gregory A Aarons4
1Institute for the Study of Behavioral Health and Addiction, Boise State University, Boise, ID, USA. natewilliams@boisestate.edu.
Implementation science : IS
|March 29, 2024
概括
领导力和组织变革实施 (LOCI) 战略通过加强领导力和气候,改善了青年心理健康服务,从而提高了基于证据的实践忠实性. 这表明了通过有针对性的组织发展改善医疗保健结果的途径.
科学领域:
- 实施科学 实施科学
- 医疗保健管理的管理
- 临床心理学 临床心理学
背景情况:
- 理论上,组织领导和气候对于在医疗保健中实施基于证据的实践 (EBP) 是至关重要的.
- 直接将这些因素与EBP成功实施联系起来的实验证据有限.
- 智慧试验调查了领导力和组织变革实施 (LOCI) 战略对青少年心理健康服务的基于测量护理 (MBC) 忠诚度的影响.
研究的目的:
- 测试LOCI战略通过哪些机制来提高对基于测量的护理 (MBC) 的忠实性.
- 检查LOCI是否增强了实施和转型领导力,这反过来影响了实施气候.
- 确定实施气候是否介导领导力改进对MBC忠诚度的影响.
主要方法:
- 一个混合型III有效性-实施试验,涉及21个青少年心理健康诊所.
- 随机分配到LOCI加MBC培训或单独进行MBC培训.
- 纵向混合效应模型和多层调解分析被用来评估领导力,气候和忠诚度超过18个月.
主要成果:
- LOCI显著改善了实施领导力和临床实施气候,效果规模很大.
- 实施领导层的改进调解了LOCI对实施气候的积极影响.
- 反过来,改善的实施环境,则调解了LOCI对MBC忠诚度的积极影响.
结论:
- 洛基战略有效地提高了青少年精神卫生机构对基于测量的护理的忠诚度.
- 这种改进是通过加强实施领导力和促进有利的实施气候来实现的.
- 调查结果强调了培养组织领导者和强有力的实施气候的重要性,以促进EBP在医疗保健中的忠诚度.
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