Applying Project ECHO (Extension for Community Health Care Outcomes) to improve addiction care in rural emergency departments.
Applying Project ECHO (Extension for Community Health Care Outcomes) to improve addiction care in rural emergency departments.
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DOI：
10.1002/aet2.10804
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发表时间：
2022-10
影响因子：
1.8
通讯作者：
Pho, Mai Tuyet
中科院分区：
文献类型：
--
作者：
Moore, P. Quincy;Tilmon, Sandra;Chhabra, Neeraj;McCabe, Daniel J.;Aks, Steven E.;Johnson, Daniel;Pho, Mai Tuyet
研究和立法的进步提高了紧急服务提供者治疗阿片类药物使用障碍（OUD）的能力，但在农村急诊部门（ED）的传播是有限的。社区卫生保健成果项目扩展（ECHO）允许社区通才通过远程指导向专家学习。我们的目的是使用ECHO来促进知识翻译，增加信心，并改变农村艾德提供者治疗OUD患者的行为。与农村艾德提供者进行了利益相关者访谈。一组艾德成瘾专家创建了一个ECHO课程，其中包含八个OUD主题。招募了艾德卫生专业人员，并完成了以艾德治疗OUD的知识和舒适度为中心的前后调查，重点关注临床实践和耻辱感。按照ECHO模式，会议包括20分钟的教学，然后由参与者提出两个案例，并由教师促进讨论。27名参与者登记; 7人参加了≥75%的会议并完成了两项调查。在这7人中，3人是医生，2人是高级实践提供者，1人是护士，1人是临床药剂师。2021年1月至12月期间，在两个队列中进行了8次1小时的课程。在5分制Likert量表上，受访者平均同意评价可接受性（平均值± SD 3.96 ± 0.64）、适当性（平均值± SD 4.18 ± 1.18）和可行性（平均值± SD 4.00 ± 1.17）的问题。参与者在测量自我效能的7分Likert量表问题上增加了1.09分（配对t检验= 2.43，p = 0.05），在测量污名化态度的4分Likert量表问题上增加了0.13分（配对t检验= 2.64，p = 0.04）。共有71%（57）的患者报告参与后临床实践发生变化，57%（4/7）的患者报告参与后科室方案发生变化。我们的艾德OUD ECHO课程成功地为农村艾德提供者创造了向艾德成瘾专家学习的模式。它受到了好评，并影响了自我报告的提供者污名化的态度，患者面对的行为和部门的举措。征聘工作具有挑战性，参与人数有限。今后的努力将以最大限度地征聘为目标。
Advancements in research and legislation have improved emergency provider ability to treat opioid use disorder (OUD), but dissemination into rural emergency departments (EDs) is limited. Project Extension for Community Healthcare Outcomes (ECHO) allows community generalists to learn from specialists through telementoring. We aimed to use ECHO to facilitate knowledge translation, increase confidence, and change behavior of rural ED providers treating patients with OUD. Stakeholder interviews were conducted with rural ED providers. A group of ED addiction experts created an ECHO curriculum with eight OUD topics. ED health professionals were recruited and completed pre/post surveys centered around knowledge and comfort with treating OUD in the ED, with focus on clinical practice and stigma. Following the ECHO model, sessions included a 20‐min didactic followed by two cases presented by participants, with discussion facilitated by faculty. Twenty‐seven participants registered; seven attended ≥75% of sessions and completed both surveys. Of the seven, three were physicians, two advanced practice providers, one nurse, and one clinical pharmacist. Eight 1‐hour sessions were conducted in two cohorts between January and December 2021. On a 5‐point Likert scale, respondents on average agreed with questions evaluating acceptability (mean ± SD 3.96 ± 0.64), appropriateness (mean ± SD 4.18 ± 1.18), and feasibility (mean ± SD 4.00 ± 1.17). Participants had a 1.09‐point increase (paired t‐test = 2.43, p = 0.05) on 7‐point Likert‐scale questions measuring self‐efficacy and a 0.13‐point change (paired t‐test = 2.64, p = 0.04) on 4‐point Likert scale questions measuring stigmatizing attitudes (reduction of attitudes). A total of 71% (5/7) reported changes in clinical practice and 57% (4/7) in departmental protocols after participation. Our ED OUD ECHO course successfully created a model for rural ED providers to learn from ED addiction experts. It was well received and impacted self‐reported provider stigmatizing attitudes, patient‐facing behavior, and departmental initiatives. Recruitment was challenging and participation was limited. Future efforts will target maximizing recruitment.
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DOI：
10.1353/cpr.2013.0043
发表时间：
2013-12-01
影响因子：
1.1
作者：
Socolovsky, Carmela;Masi, Christopher;Johnson, Daniel
通讯作者：
Johnson, Daniel
影响因子：
3.3
作者：
Arora, Sanjeev;Thornton, Karla;Scaletti, Joseph V.
通讯作者：
Scaletti, Joseph V.
影响因子：
3.7
作者：
Kerensky T;Walley AY
通讯作者：
Walley AY
影响因子：
13.8
作者：
Haffajee, Rebecca L.;Lin, Lewei Allison;Goldstick, Jason E.
通讯作者：
Goldstick, Jason E.
影响因子：
--
作者：
Arora, Sanjeev;Thornton, Karla
通讯作者：
Thornton, Karla