A facilitation model for implementing quality improvement practices to enhance outpatient substance use disorder treatment outcomes: a stepped-wedge randomized controlled trial study protocol.
A facilitation model for implementing quality improvement practices to enhance outpatient substance use disorder treatment outcomes: a stepped-wedge randomized controlled trial study protocol.
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DOI：
10.1186/s13012-020-01076-x
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发表时间：
2021-01-07
期刊：
影响因子：
--
通讯作者：
Neighbors CJ
中科院分区：
文献类型：
--
作者：
O'Grady MA;Lincourt P;Greenfield B;Manseau MW;Hussain S;Genece KG;Neighbors CJ
类阿片滥用和成瘾是一个影响公共健康以及社会和经济福利的国家危机。迫切需要提高阿片类药物使用障碍治疗质量的策略（例如，6-月保留）。物质使用障碍治疗方案受到有限资源和劳动力的挑战，这些劳动力在质量改进方法方面没有必要的经验或教育。本研究的目的是测试一种多组分临床水平干预措施，旨在帮助物质使用障碍治疗诊所实施质量改进流程，以提高阿片类药物使用障碍治疗质量的高优先级指标。一项有30个门诊治疗诊所参与的阶梯楔形随机对照试验，每年为约2000名阿片类药物使用障碍患者提供服务，将测试一种名为成瘾恢复增强辅导（CARE）的临床水平测量驱动的质量改进干预措施是否改善了（a）治疗过程质量测量（阿片类药物使用障碍的药物使用、治疗中症状和治疗进展、治疗保持）和（B）恢复结果（物质使用、健康和医疗保健利用）。CARE干预措施将包括以下组成部分：（1）员工临床培训和工具，（2）质量改进和变更管理培训，（3）外部促进，以支持质量改进流程的实施和可持续性，以及（4）客户报告的电子治疗进展工具，以支持数据驱动的决策和诊所级质量测量。该研究将利用多个数据来源来测试研究目标，包括州行政数据、客户报告的调查和治疗进展数据以及工作人员访谈和调查数据。这项研究将为该领域提供一个强有力的多成分干预测试，以提高供应商的能力，使系统的变化与质量指标。该研究还将产生可广泛分享的培训和材料，以增加质量改进的实施，并加强药物使用障碍治疗系统的临床实践。试验编号NCT 04632238 NCT 04632238于2020年11月17日在clinicaltrials.gov注册
The misuse of and addiction to opioids is a national crisis that affects public health as well as social and economic welfare. There is an urgent need for strategies to improve opioid use disorder treatment quality (e.g., 6-month retention). Substance use disorder treatment programs are challenged by limited resources and a workforce that does not have the requisite experience or education in quality improvement methods. The purpose of this study is to test a multicomponent clinic-level intervention designed to aid substance use disorder treatment clinics in implementing quality improvement processes to improve high-priority indicators of treatment quality for opioid use disorder. A stepped-wedge randomized controlled trial with 30 outpatient treatment clinics serving approximately 2000 clients with opioid use disorder each year will test whether a clinic-level measurement-driven, quality improvement intervention, called Coaching for Addiction Recovery Enhancement (CARE), improves (a) treatment process quality measures (use of medications for opioid use disorder, in-treatment symptom and therapeutic progress, treatment retention) and (b) recovery outcomes (substance use, health, and healthcare utilization). The CARE intervention will have the following components: (1) staff clinical training and tools, (2) quality improvement and change management training, (3) external facilitation to support implementation and sustainability of quality improvement processes, and (4) an electronic client-reported treatment progress tool to support data-driven decision making and clinic-level quality measurement. The study will utilize multiple sources of data to test study aims, including state administrative data, client-reported survey and treatment progress data, and staff interview and survey data. This study will provide the field with a strong test of a multicomponent intervention to improve providers’ capacity to make systematic changes tied to quality metrics. The study will also result in training and materials that can be shared widely to increase quality improvement implementation and enhance clinical practice in the substance use disorder treatment system. Trial #NCT04632238NCT04632238 registered at clinicaltrials.gov on 17 November 2020
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影响因子：
7.2
作者：
BRIGHT, RA;AVORN, J;EVERITT, DE
通讯作者：
EVERITT, DE
影响因子：
3.4
作者：
Alterman, Arthur I.;Cacciola, John S.;Lynch, Kevin G.
通讯作者：
Lynch, Kevin G.
影响因子：
3.7
作者：
DUAN, N
通讯作者：
DUAN, N
影响因子：
33.9
作者：
Czeisler, Mark E.;Lane, Rashon, I;Rajaratnam, Shantha M. W.
通讯作者：
Rajaratnam, Shantha M. W.
DOI：
10.1007/s11414-015-9466-7
发表时间：
2016-07
期刊：
The journal of behavioral health services & research
影响因子：
--
作者：
Fields D;Knudsen HK;Roman PM
通讯作者：
Roman PM