Do Collaborative Care Managers and Technology Enhance Primary Care Satisfaction with Care from Embedded Mental Health Providers?
Do Collaborative Care Managers and Technology Enhance Primary Care Satisfaction with Care from Embedded Mental Health Providers?
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协作护理管理人员和技术是否可以通过嵌入式心理健康提供者的护理提高初级护理满意度？
DOI：
10.1007/s11606-020-05660-1
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发表时间：
2020
影响因子：
5.7
通讯作者：
Rubenstein,LisaV
中科院分区：
文献类型：
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作者：
Leung,LucindaB;Young,AlexanderS;Heyworth,Leonie;Rose,Danielle;Stockdale,Susan;Graaff,ALaurie;Dresselhaus,TimothyR;Rubenstein,LisaV
背景为了改善精神卫生保健的可及性，退伍军人健康管理局（VA）在全国诊所实施了初级保健-精神卫生一体化（PC-MHI）。初级保健临床领导者的满意度可以告知模型的实施，并可能通过协作护理管理者和支持跨专业collaboration.Objective. Objective技术来促进。（1）确定初级保健临床领导者对嵌入式心理健康提供者在一系列条件下的护理的总体满意度，（2）检查总体满意度与两个程序功能之间的关联（护理管理人员，技术）。设计在一个VA地区的横断面组织调查（南加州、亚利桑那和新墨西哥州），2018年，每个VA初级保健诊所的69名医生或其他指定的临床领导人主要措施我们评估了初级保健临床领导人对四组条件下嵌入式精神卫生保健的满意度：目标、非目标心理健康、行为健康、自杀风险管理。他们还回答了精神卫生保健管理人员的可用性和信息技术（远程健康，电子咨询，即时通讯）的充分性。我们研究了满意度和两个程序功能之间的关系，使用χ 2检验和多变量regressions.Key ResultsMost初级保健临床领导人“非常满意”的目标焦虑（71%）和抑郁症（69%）的护理，但不是其他常见的条件（37%酒精滥用，19%疼痛）。护理经理的可用性与嵌入式心理健康提供者对抑郁症（p= .02）和焦虑护理（p= .02）的“非常满意”反应显着相关。高度评价充分的通信技术（仅19%）与“非常满意”的反应自杀风险管理（P= .002）。ConclusionsCare嵌入式心理健康提供者的抑郁症和焦虑症是非常令人满意的，这可能会引导改善不太满意的条件（酒精滥用，疼痛）。观察到的整体满意度和协作护理功能之间的关联可以告知诊所如何根据优先条件优化人员配置和技术。
BackgroundTo improve mental health care access, the Veterans Health Administration (VA) implemented Primary Care-Mental Health Integration (PC-MHI) in clinics nationally. Primary care clinical leader satisfaction can inform model implementation and may be facilitated by collaborative care managers and technology supporting cross-specialty collaboration.Objective(1) To determine primary care clinical leaders’ overall satisfaction with care from embedded mental health providers for a range of conditions and (2) to examine the association between overall satisfaction and two program features (care managers, technology).DesignCross-sectional organizational survey in one VA region (Southern California, Arizona, and New Mexico), 2018.ParticipantsSixty-nine physicians or other designated clinical leaders in each VA primary care clinic (94% response rate).Main MeasuresWe assessed primary care clinical leader satisfaction with embedded mental health care on four groups of conditions: target, non-target mental health, behavioral health, suicide risk management. They additionally responded about the availability of mental health care managers and the sufficiency of information technology (telemental health, e-consult, instant messaging). We examined relationships between satisfaction and the two program features usingχ2tests and multivariable regressions.Key ResultsMost primary care clinical leaders were “very satisfied” with care for targeted anxiety (71%) and depression (69%), but not for other common conditions (37% alcohol misuse, 19% pain). Care manager availability was significantly associated with “very satisfied” responses for depression (p= .02) and anxiety care by embedded mental health providers (p= .02). Highly rated sufficiency of communication technology (only 19%) was associated with “very satisfied” responses to suicide risk management (p= .002).ConclusionsCare from embedded mental health providers for depression and anxiety was highly satisfactory, which may guide improvement among less satisfactory conditions (alcohol misuse, pain). Observed associations between overall satisfaction and collaborative care features may inform clinics on how to optimize staffing and technology based on priority conditions.
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退伍军人事务部初级保健诊所的抑郁症筛查、评估和管理
影响因子：
5.7
作者：
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DOI：
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发表时间：
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期刊：
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DOI：
10.1186/s13012-018-0780-3
发表时间：
2018-06-26
期刊：
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影响因子：
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作者：
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影响因子：
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DOI：
10.2146/ajhp130294
发表时间：
2013
期刊：
American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
影响因子：
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作者：
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通讯作者：
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