在农村初级保健机构中实施技术增强的精神病学协作护理模式的障碍和促进者:混合方法实施案例研究
Ryan Kruis1,2, Emily Johnson3, Constance Guille4
1Manatt Health Strategies, Chicago, IL, USA. rkruis@manatt.com.
在农村诊所实施远程医疗支持的协作护理模式 (CoCM) 改善了行为健康 (BH) 接入. 动态适应过程 (DAP) 指导了适应,克服障碍,利用促进者为成功的农村BH服务提供提供.
科学领域:
- 实施科学 实施科学
- 农村卫生 农村卫生
- 行为健康服务 行为健康服务
背景情况:
- 精神病学协作护理管理 (CoCM) 为农村行为健康 (BH) 接入挑战提供了解决方案.
- 在农村环境中实施CoCM是复杂的,需要定制的战略.
- 这项研究探讨了在南卡罗来纳州农村诊所使用动态适应过程 (DAP) 实施远程医疗支持的CoCM计划.
研究的目的:
- 检查在南卡罗来纳州四个农村诊所实施远程医疗支持的CoCM计划.
- 在动态适应过程 (DAP) 框架内识别障碍,促进者和适应策略.
- 评估CoCM在改善农村BH接入方面的可行性和有效性.
主要方法:
- 采用混合方法,嵌入式,按时间顺序的案例研究方法.
- 数据收集包括调查,重点小组,关键信息人采访和行政数据,这些数据使用编织方法进行整合.
- 该研究纵向分析了DAP阶段:探索,准备,实施和维持.
主要成果:
- 确定的主要障碍是农村地区BH资源的稀缺性.
- 促进者包括强烈的预期适应性,患者需求,患者兴趣和提供者的参与.
- 该试点在八个月内招募了99名患者,在实施后报告的高供应商满意度.
结论:
- 动态适应过程 (DAP) 在定制农村环境中的CoCM实施方面非常有效.
- DAP提供了一份路线图,通过适应来解决情境障碍和促进者.
- 这种方法支持BH服务在服务不足的农村社区成功融入初级保健.
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