Adaptation of the collaborative care model to integrate behavioral health care into a low-barrier HIV clinic.
Adaptation of the collaborative care model to integrate behavioral health care into a low-barrier HIV clinic.
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DOI：
10.1177/26334895231167105
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发表时间：
2023-01
影响因子：
--
通讯作者：
Chwastiak, Lydia
中科院分区：
文献类型：
--
作者：
Dombrowski, Julia C.;Halliday, Scott;Tsui, Judith I.;Rao, Deepa;Sherr, Kenneth;Ramchandani, Meena S.;Emerson, Ramona;Fleming, Mark;Wood, Teagan;Chwastiak, Lydia
关键词：
协作护理管理（CoCM）模式是一种将行为健康护理整合到非精神病环境中的循证干预措施。CoCM已在初级保健诊所进行了广泛的研究，但在非传统诊所，如那些专门为高需求，复杂的患者提供护理，实施还没有得到很好的描述。我们将CoCM应用于一个低障碍的HIV诊所，该诊所为患有高水平精神疾病、物质使用和住房不稳定的患者群体提供无障碍医疗护理。探索、准备、实施和维持模式在实施CoCM的各个阶段指导实施活动和支持。循证干预调整和修改报告框架指导我们记录CoCM的护理过程要素和结构要素的调整。我们使用了一个多组件的策略来实现适应CoCM模型。在这篇文章中，我们描述了我们在实施的前6个月的经验。需要调整CoCM模型的关键背景因素是诊所团队结构、缺乏预定预约、患者人群的高度复杂性以及患者护理优先级竞争的时间限制，所有这些都需要模型具有很大的灵活性。护理过程的元素进行了调整，以提高适应的背景下的干预，但核心结构要素的CoCM保持。CoCM模型可以适用于比普通初级保健诊所需要更多灵活性的环境，同时保持干预的核心要素。关于这个话题我们已经知道了什么？协作护理管理是一种基于证据的干预措施，将行为卫生保健纳入初级医疗保健。该模型采用任务共享的方法，其中由远程精神科医生监督的行为健康护理经理与初级医疗团队合作。这篇论文补充了什么？我们描述了适应的协作护理管理模式的低障碍艾滋病毒护理诊所。调整是必要的，因为诊所提供的所有护理都是在无预约的基础上，团队结构不同于通常的初级保健，病人群体有复杂的医疗和社会需求。对实践、研究或政策有何影响？我们的经验可以为其他医疗机构实施协作护理管理提供信息，这些医疗机构旨在为高需求，复杂的患者群体提供护理。
The collaborative care management (CoCM) model is an evidence-based intervention for integrating behavioral health care into nonpsychiatric settings. CoCM has been extensively studied in primary care clinics, but implementation in nonconventional clinics, such as those tailored to provide care for high-need, complex patients, has not been well described. We adapted CoCM for a low-barrier HIV clinic that provides walk-in medical care for a patient population with high levels of mental illness, substance use, and housing instability. The Exploration, Preparation, Implementation, and Sustainment model guided implementation activities and support through the phases of implementing CoCM. The Framework for Reporting Adaptations and Modifications to Evidence-Based Interventions guided our documentation of adaptations to process-of-care elements and structural elements of CoCM. We used a multicomponent strategy to implement the adapted CoCM model. In this article, we describe our experience through the first 6 months of implementation. The key contextual factors necessitating adaptation of the CoCM model were the clinic team structure, lack of scheduled appointments, high complexity of the patient population, and time constraints with competing priorities for patient care, all of which required substantial flexibility in the model. The process-of-care elements were adapted to improve the fit of the intervention with the context, but the core structural elements of CoCM were maintained. The CoCM model can be adapted for a setting that requires more flexibility than the usual primary care clinic while maintaining the core elements of the intervention. What is already known about this topic? Collaborative care management is an evidence-based intervention to integrate behavioral health care into primary medical care. The model uses a task-sharing approach in which a behavioral health care manager who is supervised by a remote psychiatrist works with the primary medical team. What does this paper add? We describe adaptation of the collaborative care management model for a low-barrier HIV care clinic. Adaptation was necessary because the clinic provides all care on a walk-in basis, the team structure differs from usual primary care, and the patient population has complex medical and social needs. What are the implications for practice, research or policy? Our experience can inform implementation of collaborative care management into other medical settings that are designed to provide care for high-need, complex patient populations.
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影响因子：
4.4
作者：
Bulsara SM;Wainberg ML;Newton-John TRO
通讯作者：
Newton-John TRO
DOI：
10.1097/qai.0000000000001889
发表时间：
2019-02-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Lemons A;DeGroote N;Peréz A;Craw J;Nyaku M;Broz D;Mattson CL;Beer L
通讯作者：
Beer L
影响因子：
2.6
作者：
Cubillos L;Bartels SM;Torrey WC;Naslund J;Uribe-Restrepo JM;Gaviola C;Díaz SC;John DT;Williams MJ;Cepeda M;Gómez-Restrepo C;Marsch LA
通讯作者：
Marsch LA
DOI：
10.1007/s43477-022-00048-1
发表时间：
2022
期刊：
Global implementation research and applications
影响因子：
--
作者：
Albrecht, Erin C;Sherman, Lindsay;Fixsen, Amanda;Steffen, Julie
通讯作者：
Steffen, Julie
影响因子：
4.9
作者：
Dombrowski, Julia C.;Ramchandani, Meena;Golden, Matthew R.
通讯作者：
Golden, Matthew R.