Implementation of behavioral health interventions in real world scenarios: Managing complex change.
Implementation of behavioral health interventions in real world scenarios: Managing complex change.
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DOI：
10.1037/fsh0000239
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发表时间：
2017-03
期刊：
影响因子：
--
通讯作者：
Cohen DJ
中科院分区：
文献类型：
--
作者：
Clark KD;Miller BF;Green LA;de Gruy FV;Davis M;Cohen DJ
当一个实践决定为病人整合医疗和行为健康护理时，它就开始了对护理设计和提供方式的彻底重新制定，成功取决于在一个复杂系统中管理复杂的变化。我们研究了在整合行为健康和医疗保健时管理变化的方式。19个初级保健和社区精神卫生实践的观察性跨病例比较研究。我们通过实践调查、观察和半结构化访谈收集了混合方法数据。我们使用数据驱动的紧急方法分析数据。领导层为管理行为健康与医疗照护整合之变革所采取的变革管理策略包括：（a）倡导以整合照护为重点的使命与愿景;（B）促进合作，以人口照护为重点，以团队为基础的方法;（c）注重学习，包括将变革进程视为一个持续的过程，并创造一种促进反思和不断改进的文化;（d）利用数据管理变革;（e）制定一体化筹资办法。本文报告了实践领导者所采用的变革管理策略，以整合护理，观察到的独立调查。我们提供了一套基于经验的可操作建议，这些建议与希望有效管理与综合初级保健相关的复杂变化的一系列领导者（政策制定者，医疗总监）和实践成员相关。
A practice embarks on a radical reformulation of how care is designed and delivered when it decides to integrate medical and behavioral health care for its patients and success depends on managing complex change in a complex system. We examined the ways change is managed when integrating behavioral health and medical care. Observational cross-case comparative study of 19 primary care and community mental health practices. We collected mixed methods data through practice surveys, observation, and semistructured interviews. We analyzed data using a data-driven, emergent approach. The change management strategies that leadership employed to manage the changes of integrating behavioral health and medical care included: (a) advocating for a mission and vision focused on integrated care; (b) fostering collaboration, with a focus on population care and a team-based approaches; (c) attending to learning, which includes viewing the change process as continuous, and creating a culture that promoted reflection and continual improvement; (d) using data to manage change, and (e) developing approaches to finance integration. This paper reports the change management strategies employed by practice leaders making changes to integrate care, as observed by independent investigators. We offer an empirically based set of actionable recommendations that are relevant to a range of leaders (policymakers, medical directors) and practice members who wish to effectively manage the complex changes associated with integrated primary care.
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影响因子：
1.8
作者：
Cohen, D;McDaniel, RR;Stange, KC
通讯作者：
Stange, KC
DOI：
10.3122/jabfm.2015.s1.150087
发表时间：
2015-09-01
影响因子：
2.9
作者：
Davis, Melinda M.;Balasubramanian, Bijal A.;Cohen, Deborah J.
通讯作者：
Cohen, Deborah J.
DOI：
10.3122/jabfm.2015.s1.150042
发表时间：
2015-09-01
影响因子：
2.9
作者：
Cohen, Deborah J.;Davis, Melinda;Miller, Benjamin F.
通讯作者：
Miller, Benjamin F.
影响因子：
5.5
作者：
Beer, M
通讯作者：
Beer, M
DOI：
10.3122/jabfm.2015.s1.150054
发表时间：
2015-09-01
影响因子：
2.9
作者：
Hall, Jennifer;Cohen, Deborah J.;Miller, Benjamin F.
通讯作者：
Miller, Benjamin F.