一个基于实践的实施策略包,用于在初级保健中整合行为健康:一个矩阵式的多个案例研究
Gretchen Buchanan1,2, Kelley McCall3, Lorella Palazzo4
1Redleaf Center for Family Healing, Hennepin Healthcare Research Institute, 701 Park Ave, Suite S3, Minneapolis, MN, 55415, USA. gretchen.buchanan@hcmed.org.
在初级保健中实施综合行为健康 (IBH) 需要持续的努力,关键人员,支持性政策,以及拥抱成功扩展的组织文化. 关键策略包括资金,组建团队,角色适应和数据反.
科学领域:
- 医疗保健提供研究 医疗保健研究
- 实施科学 实施科学
- 初级保健领域的创新.
背景情况:
- 综合行为健康 (IBH) 通过嵌入行为健康专业人员来满足患者需求和支持医疗提供者来增强初级保健.
- 尽管有证据基础,IBH传播在现实实践中面临着重大实施障碍.
- 需要对临床试验之外的IBH实施进行系统研究,以优化扩展战略.
研究的目的:
- 系统地研究在初级保健机构中实施综合行为健康 (IBH).
- 确定在各种医疗保健系统中实施和维持IBH的有效策略.
- 为优化IBH实施和提高其扩展速度提供基础.
主要方法:
- 快速民族学评估 (REA) 涉及现场考察,采访和调查,在三个医疗保健系统的五个初级保健诊所进行.
- 使用IBH跨模型框架 (CMF),实用,稳健实施和可持续性模型 (PRISM) 和实施变革专家建议 (ERIC) 分类的演数据编码.
- 矩阵化多个案例研究设计,以确定IBH的有效实施策略.
主要成果:
- 诊所主要为低收入,资源有限的人群提供服务,展示了共同的IBH实施模式,障碍和策略.
- 成功的策略包括获得资金,组建新的临床团队,调整专业角色,促进适应能力,改善向提供者传递数据,以及代过程检查.
- 规范化过程理论 (NPT) 机制 (一致性,认知参与,集体行动,反射监测) 在成功的IBH实施中是显而易见的.
结论:
- IBH实施是实施,维护和改进多个特定流程的持续过程.
- 了解IBH,支持IBH的政策和计划,以及规范IBH的组织文化,对IBH的持续成功至关重要.
- 了解和优化实施策略是加速IBH在初级保健中的广泛采用的关键.
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