The DIAMOND initiative: implementing collaborative care for depression in 75 primary care clinics
The DIAMOND initiative: implementing collaborative care for depression in 75 primary care clinics
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DOI：
10.1186/1748-5908-8-135
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发表时间：
2013-11-16
影响因子：
7.2
通讯作者：
Van de Ven, Andrew H.
中科院分区：
文献类型：
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作者：
Solberg, Leif I.;Crain, A. Lauren;Van de Ven, Andrew H.
背景：许多关于改善初级保健中抑郁症的协作护理模型的随机试验尚未描述该模型的实施和维护。本文报告了参与 DIAMOND Initiative（明尼苏达州抑郁症改善 - 提供新方向）的 75 家初级保健诊所实施和维持协作护理流程变革的方式和程度。方法：每个诊所都接受了实施该模型的七个组成部分的培训，并参与了持续的评估和促进活动。对于本研究，临床流程实施的评估是通过每个诊所站点的医师领导和诊所经理在三个时间点完成调查来完成的。每个诊所的医师领导在实施前以及实施后一年和两年内完成了对各种实践系统的存在情况的调查。诊所管理人员还完成了一项有关组织准备情况和实施策略的调查。结果：调查回复率为 96% 至 100%。系统调查证实，DIAMOND 抑郁症实践系统的实施程度非常高（差异很大）（平均值为 24.4 +/- 14.6%），一年时为 57.0 +/- 21.0%（P =
Background: The many randomized trials of the collaborative care model for improving depression in primary care have not described the implementation and maintenance of this model. This paper reports how and the degree to which collaborative care process changes were implemented and maintained for the 75 primary care clinics participating in the DIAMOND Initiative (Depression Improvement Across Minnesota-Offering a New Direction).Methods: Each clinic was trained to implement seven components of the model and participated in ongoing evaluation and facilitation activities. For this study, assessment of clinical process implementation was accomplished via completion of surveys by the physician leader and clinic manager of each clinic site at three points in time. The physician leader of each clinic completed a survey measure of the presence of various practice systems prior to and one and two years after implementation. Clinic managers also completed a survey of organizational readiness and the strategies used for implementation.Results: Survey response rates were 96% to 100%. The systems survey confirmed a very high degree of implementation (with large variation) of DIAMOND depression practice systems (mean of 24.4 +/- 14.6%) present at baseline, 57.0 +/- 21.0% at one year (P =