与成功实施FLOW相关的因素,以改善心理健康准入:一项混合方法研究
Natalie E Hundt1,2,3, Bo Kim4,5,6, Maribel Plasencia1,2,3
1VA HSR&D Houston Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA.
Translational behavioral medicine
|September 26, 2024
概括
成功实施FLOW计划,将专业精神健康患者转移到初级保健,与积极的干预感知和强大的内部促进者有关. 这些因素是改善获得心理健康服务的关键.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 实施科学 实施科学
- 心理健康服务 心理健康服务
背景情况:
- 该计划旨在通过将稳定患者转移到初级保健来改善获得专业心理健康 (SMH) 护理的机会.
- 在九个VA地点实施FLOW计划时,成功率显著差异.
- 了解影响实施的站点级因素对于程序优化至关重要.
研究的目的:
- 确定与成功实施FLOW计划相关的现场级因素.
- 通过突出关键的促进者和障碍来指导未来的实施努力.
- 为提高心理健康服务转型的覆盖范围和有效性的战略提供信息.
主要方法:
- 一个集群随机化阶梯试验涉及九个VA网站.
- 采用矩阵式多个案例研究方法的混合方法方法.
- 以实施研究综合框架 (CFIR) 为指导的分析,以比较实施指标.
主要成果:
- 实施成功率更高的网站 (以退伍军人过渡来衡量) 显示了对FLOW干预措施 (CFIR领域:创新) 的积极看法.
- 以康复为导向的护理文化,优先实施,以及较低的心理健康提供者周转率与更大的成功有关 (CFIR领域:内部设置).
- 具有领导作用或跨诊所联系的优秀的内部辅导员对实施产生了积极的影响 (CFIR领域:个体特征).
结论:
- 对干预的看法,组织文化,提供者稳定性和促进者定位对于成功实施FLOW计划至关重要.
- 工作人员数量,领导支持和组织准备等因素与实施成功没有一致的关系.
- 识别这些关键因素可以帮助针对需要帮助的地点提供额外的支持,以成功采用计划.
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