改变心理治疗服务的有效性和公平性:英格兰NHS说话疗法计划中的案例研究
Katy James1, David Saxon2, Michael Barkham3
1Department of Psychology, University of Sheffield, Norfolk and Suffolk NHS Foundation Trust, Vita Health Group, Sheffield, England.
Administration and policy in mental health
|August 17, 2024
概括
实施学习健康系统改善了心理治疗服务. 患者的治疗结果和公平性有所提高,临床医生主导的干预措施显著减少了从业人员的变化.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 心理干预 心理干预
- 提高质量 提高科学 提高质量
背景情况:
- 政府的授权要求提供心理治疗服务,以改善患者的治疗结果并减少从业人员的变化.
- 学习健康系统为将证据纳入实践和改善医疗保健服务提供提供了一个框架.
- 案例研究对于理解在现实环境中实施复杂干预措施是有价值的.
研究的目的:
- 在心理治疗服务中使用学习健康系统方法实施康复计划.
- 根据政府机构的授权,提高患者的结果 (有效性) 和降低从业者的变化 (公平性).
- 评估管理层和临床医生主导干预措施对服务效率和公平性的影响.
主要方法:
- 一个案例研究设计,有三个18个月的阶段:追溯基线,管理层主导的干预和临床医生主导的干预.
- 使用了学习卫生系统的组件,包括国家授权的患者结果数据.
- 采用多级建模来分析从业者的影响和可靠的改善率,以分析核心和整体从业者样本.
主要成果:
- 在核心和整体从业者样本的各个阶段,患者的治疗结果都得到了持续的改善.
- 实践者变异性在不同阶段下降,除了整个样本的管理主导干预之外.
- 与管理层主导的干预相比,临床医生主导的干预显著减少了从业者效应 (核心样本超过60%,整个样本近50%).
结论:
- 多种学习健康系统组件的整合可以显著提高心理治疗服务的有效性和公平性.
- 临床医生主导的干预措施在减少从业人员的变化方面似乎特别有效,从而促进了更大的护理公平.
- 这项研究提供了证据,证明了学习健康系统在改善精神卫生保健服务的成功应用.
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