在卫生中心实施综合行为健康的策略
Ann M Nguyen1, Rebecca A Klege2, Theresa Menders2
1From the Center for State Health Policy, Rutgers University, New Brunswick, NJ (AMN); Henry J. Austin Health Center, Trenton, NJ (RAK); University of Illinois Chicago, School of Public Health, Chicago, IL (TM); Institute for Health, Healthcare Policy and Aging Research, Rutgers University, New Brunswick, NJ (CV); Rutgers University Behavioral Health Care, New Brunswick, NJ (SM); Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ (BFC). anguyen@ifh.rutgers.edu.
成功实施综合行为健康 (IBH) 需要具体的策略. 关键因素包括强有力的领导,量身定制的培训,专用空间,以及在联邦合格卫生中心 (FQHC) 和社区卫生中心 (CHC) 收费和安排的高效系统.
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
- 行为健康整合行为健康整合
背景情况:
- 综合行为健康 (IBH) 将心理健康服务嵌入到初级保健机构中.
- 尽管IBH模型充满了希望,但其有限的实施已经被观察到.
- 在新泽西州 (2013-2019) 的一个示范项目集中在联邦合格卫生中心 (FQHC) 和社区卫生中心 (CHC) 内的IBH实施上.
研究的目的:
- 确定有效的战略,以实现IBH模型的成功实施和可持续性.
- 检查促进IBH在FQHC和CHC长期成功的因素.
- 了解如何克服IBH整合在初级保健中的障碍.
主要方法:
- 使用半结构面试对18名初级保健和行为健康临床医生进行定性研究.
- 在2022年对参加示范项目的10个FQHC/CHC进行了采访.
- 普罗克特实施结果框架指导问题,以评估实施结果,如可接受性,可行性和可持续性.
主要成果:
- 所有参与的FQHC/CHC都在项目后三年继续提供IBH服务,表明成功实施和可持续性.
- 关键策略包括选择经验丰富的变革领导者,提供关于简短干预的具体培训,为新员工建立持续培训,为顾问创造专用物理空间,并优化调度系统.
- 确定本地IBH计费代码,政策和程序对于金融可持续性至关重要.
结论:
- 变革管理至关重要,但IBH需要独特的策略来应对态度,组织和财务方面的挑战.
- 需要多方面的方法来克服阻碍IBH整合的持续障碍.
- 未来的IBH实施应采用全面的战略,以成功和可持续地融入初级保健.
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