Strategic Implementation Planning for Integrated Behavioral Health Services in Pediatric Primary Care.
Strategic Implementation Planning for Integrated Behavioral Health Services in Pediatric Primary Care.
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DOI：
10.1177/2633489520987558
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发表时间：
2021-01-01
影响因子：
--
通讯作者：
Young JF
中科院分区：
文献类型：
--
作者：
Mautone JA;Wolk CB;Cidav Z;Davis MF;Young JF
在单一环境中提供身体和行为健康服务与提高护理质量和降低医疗保健成本有关。很少有卫生系统实施综合护理开发的概念模型和有针对性的测量策略先验的眼睛对采用，实施，维持和评估。这是实地的一个广泛挑战，因此很难理清执行工作成功或失败的原因。本文讨论了战略实施和评估规划的儿科综合保健计划在一个大型卫生系统。我们的团队开发了一个逻辑模型，该模型定义了资源和社区特征、项目组成部分、评估活动、短期活动以及中期和预期的长期患者、临床医生和实践相关结果。该模型是根据研究和利益相关者的投入设计的，以支持该计划的战略实施和评估。对于逻辑模型的每个方面，选择测量组。初步实施的数据和中间结果，从试点的五个做法，在30实践儿科初级保健网络，以说明如何逻辑模型和评估计划已被用来指导迭代过程中的程序开发。在试点两年期间，共完成了4 619次办公室访问。初级保健临床医生对综合初级保健计划非常满意，并就如何进一步改进该计划提供了反馈。初级保健团队和行为健康提供者的成员认为，该计划在试点第二年后相对较好地融入了实践。这个逻辑模型和评估计划为未来的项目提供了一个模板，整合了非专业精神卫生环境中的行为健康服务，包括儿科初级保健，并可广泛用于提供实施和评估活动的结构，并促进有效举措的复制。多达五分之一的青年有心理健康问题;然而，这些青年中的大多数没有得到他们所需要的照顾。许多年轻人寻求他们的初级保健医生的支持。儿科初级保健实践越来越多地将行为健康临床医生纳入护理团队，以改善获得服务的机会，并鼓励高质量的团队护理。“行为健康整合”的定义因学科和组织而异，并且对于在大多数儿科环境中如何实际实施整合行为健康护理知之甚少。此外，方案评价活动没有包括对长期成果的彻底审查。本文提供了详细的信息，在儿科初级保健的综合行为健康计划的实施规划和评估活动。这项工作一直由一个逻辑模型，一个重要的执行科学工具，以指导新方案的开发和评估，并促进复制指导。我们开发的逻辑模型和测量计划为政策制定者、研究人员和临床医生提供了一个指南，帮助他们在其他系统和社区环境中开发和评估类似的项目。这项工作将使更多的采用，实施和维持综合护理模式，并增加获得高质量护理的机会。
Delivering physical and behavioral health services in a single setting is associated with improved quality of care and reduced health care costs. Few health systems implementing integrated care develop conceptual models and targeted measurement strategies a priori with an eye toward adoption, implementation, sustainment, and evaluation. This is a broad challenge in the field, which can make it difficult to disentangle why implementation is or is not successful. This article discusses strategic implementation and evaluation planning for a pediatric integrated care program in a large health system. Our team developed a logic model, which defines resources and community characteristics, program components, evaluation activities, short-term activities, and intermediate and anticipated long-term patient-, clinician-, and practice-related outcomes. The model was designed based on research and stakeholder input to support strategic implementation and evaluation of the program. For each aspect of the logic model, a measurement battery was selected. Initial implementation data and intermediate outcomes from a pilot in five practices in a 30-practice pediatric primary care network are presented to illustrate how the logic model and evaluation plan have been used to guide the iterative process of program development. A total of 4,619 office visits were completed during the 2 years of the pilot. Primary care clinicians were highly satisfied with the integrated primary care program and provided feedback on ways to further improve the program. Members of the primary care team and behavioral health providers rated the program as being relatively well integrated into the practices after the second year of the pilot. This logic model and evaluation plan provide a template for future projects integrating behavioral health services in non-specialty mental health settings, including pediatric primary care, and can be used broadly to provide structure to implementation and evaluation activities and promote replication of effective initiatives. Up to 1 in 5 youth have difficulties with mental health; however, the majority of these youth do not receive the care they need. Many youth seek support from their primary care clinicians. Pediatric primary care practices have increasingly integrated behavioral health clinicians into the care team to improve access to services and encourage high-quality team-based care. Definitions of “behavioral health integration” vary across disciplines and organizations, and little is known about how integrated behavioral health care is actually implemented in most pediatric settings. In addition, program evaluation activities have not included a thorough examination of long-term outcomes. This article provides detailed information on the implementation planning and evaluation activities for an integrated behavioral health program in pediatric primary care. This work has been guided by a logic model, an important implementation science tool to guide the development and evaluation of new programs and promote replication. The logic model and measurement plan we developed provides a guide for policy makers, researchers, and clinicians seeking to develop and evaluate similar programs in other systems and community settings. This work will enable greater adoption, implementation, and sustainment of integrated care models and increase access to high-quality care.
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影响因子：
1.5
作者：
Arora, Prerna G.;Godoy, Leandra;Hodgkinson, Stacy
通讯作者：
Hodgkinson, Stacy
影响因子：
3.1
作者：
Laraque, Danielle;Adams, Richard;Boscarino, Joseph A.
通讯作者：
Boscarino, Joseph A.
DOI：
10.1007/s10880-017-9509-8
发表时间：
2017-12-01
影响因子：
2.2
作者：
Godoy, Leandra;Long, Melissa;Beers, Lee
通讯作者：
Beers, Lee
DOI：
10.1097/dbp.0000000000000490
发表时间：
2017-10
期刊：
Journal of developmental and behavioral pediatrics : JDBP
影响因子：
--
作者：
Fiks AG;Mayne SL;Michel JJ;Miller J;Abraham M;Suh A;Jawad AF;Guevara JP;Grundmeier RW;Blum NJ;Power TJ
通讯作者：
Power TJ
DOI：
10.1007/s11414-015-9475-6
发表时间：
2017-04
期刊：
The journal of behavioral health services & research
影响因子：
--
作者：
Powell BJ;Beidas RS;Lewis CC;Aarons GA;McMillen JC;Proctor EK;Mandell DS
通讯作者：
Mandell DS