缩小股权差距,因为我们接近零隔离:质量改进项目的成功有些人怀疑可以做到
Clive Bensemann1, Jess Drummond1, Karen O'Keeffe1
1Mental Health and Addiction Quality Improvement Programme, Te Tāhū Hauora Health Quality and Safety Commission, Wellington, New Zealand.
概括
减少精神卫生服务中的孤立是可以实现的. 奥特罗亚新西兰新西兰新西兰
科学领域:
- 公共卫生 公共卫生
- 心理健康服务研究 心理健康服务研究
- 健康 公平 卫生 公平
背景情况:
- 在全球范围内,精神健康住院病房的隔离仍然是一个问题,特别关注其不公平的应用.
- 新西兰的Te Tāhū Hauora健康质量和安全委员会在2018年启动了一个项目,以消除隔离.
- 解决不公平的隔离率,特别是对于土著人口来说,是改善精神卫生保健的关键目标.
研究的目的:
- 描述一项旨在消除心理健康住院病房隔离的全国性倡议的实施和成果.
- 评估共同设计的双文化变革方案对隔离率和种族平等的影响.
- 评估涉及临床团队,消费者和家庭的协作方法在减少隔离的有效性.
主要方法:
- 实施通过全国性的形成性协作共同设计的双文化变革包.
- 将临床团队,消费者,家庭和 whānau 纳入共同设计和实施过程.
- 系统地收集和分析结果指标,包括隔离率,持续时间和病例数,按种族分类.
主要成果:
- 平均每月隔离率从6.4% (基线:2019年9月12个月) 降至4.3% (到2024年6月).
- 毛利精神健康消费者 (从9.9%降至6.0%) 和非毛利/非太平洋消费者 (从4.0%降至2.3%) 的隔离率显著降低.
- 在精神卫生服务中,隔离的总体发生率和不公平使用率明显下降.
结论:
- 消除隔离,特别是它在土著人口中不公平的应用,是可以实现的.
- 关键的成功因素包括真正的共同设计,强有力的领导,与土著群体和受影响个人的真实伙伴关系,以及严格的数据测量.
- 这些发现支持实施基于证据的,文化响应的策略的可行性,以提高心理健康环境中的安全和尊严.
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