Adapting Coordinated Specialty Care in the Post COVID-19 Era

在后 COVID-19 时代调整协调专业护理

• 批准号: 10193474
• 负责人: LISA B. DIXON
• 金额: $ 32.43万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-15 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10193474
• 关键词: Ambulatory Care Facilities; Appointment; Award; Businesses; COVID-19; Caring; Characteristics; Client; Code; Cognitive deficits; Communities; Coupled; Creativeness; Data; Data Collection; Decision Making; E-learning; Education; Effectiveness; Employment; Enrollment; Environment; Family; Family member; Focus Groups; Goals; Government Agencies; Health Services; Healthcare Systems; High Prevalence; Hospitalization; Hospitals; Infection; Infrastructure; Intervention; Interview; Learning; Location; Low Prevalence; Medical; Medication Management; Methods; Modeling; Modification; Needs Assessment; Neurobehavioral Manifestations; New York; Outcome; Participant; Penetration; Persons; Phase; Policies; Population; Practice based research; Process; Program Evaluation; Protocols documentation; Provider; Psychiatric therapeutic procedure; Psychotherapy; Psychotic Disorders; Regulation; Reporting; Risk Factors; Schools; Services; Shock; Site; Subgroup; Supported Employment; Symptoms; System; Technology; Time; Training; Work; base; behavioral health; care outcomes; care systems; evidence base; experience; health care delivery; implementation science; innovation; loved ones; medical specialties; outreach; peer; programs; racial and ethnic disparities; rural area; service delivery; service utilization; suburb; suicidal risk; telehealth; trend

Coordinated Specialty Care (CSC) programs provide evidence-based services for young people with recent onset of a psychotic disorder. New York State's program, OnTrackNY is a nationally recognized model of CSC treatment. OnTrackNY provides coordinated, team-based services and has demonstrated improvements in symptoms, functioning, hospitalization, and work/school participation. The rapid rise of COVID-19 has created shocks to the health care system, producing numerous rapid changes in behavioral health service delivery, including telehealth, in the absence of guidance from evidence or experience. It is unclear how these changes will impact the need for and delivery of psychiatric care and client outcomes. OnTrack Central, an intermediary organization responsible for training and implementation support of OnTrackNY programs, has created systems for multi-level stakeholder engagement, a centralized data collection protocol for quality improvement and evaluation of program fidelity, and a mechanism to support practice based-research. Our daily engagement of the OnTrackNY network has revealed how recent changes are dramatically impacting CSC services. In 2019, OnTrackNY was awarded a hub within the Early Psychosis Intervention Network (EPINET) to advance a learning health care system (LHS). The breadth of OnTrackNY sites coupled with OnTrack Central oversight provides an opportunity to examine the impacts of the COVID-19 crisis in New York State. The diversity of the 23 OnTrackNY teams located throughout the state enables examination of settings with high and low prevalence of COVID-19 infections and diverse regulatory and workforce environments. The OnTrackNY network includes programs that operate within variable regulations (outpatient clinics at community agencies, state-operated facilities, and community and academic hospitals in urban, suburban, and rural areas) with very diverse participant populations. This project will examine the implications of modifications to service delivery within the OnTrackNY LHS during and after the COVID-19 crisis. We will use the implementation science framework, Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) to systematically evaluate modifications made and ascertain their impact. We will utilize integrative mixed methods, including qualitative interviews and focus groups with stakeholders (clients, families, providers and decision makers at the state and local levels) and analysis of OnTrackNY program data The project aims to assess: 1) the implications of governmental and agency level policy changes and how these decisions impact team staffing and functioning; 2) implications for delivery of CSC services; and 3) impact on client-level care processes (e.g. utilization of services) and outcomes. The goal is to develop a CSC Model Adaptation Guide that will be fidelity-consistent, and associated with consistent engagement, service utilization or favorable outcomes of care.

协调专业护理（CSC）计划为年轻人提供基于证据的服务 心理疾病的最新发作。纽约州的计划，OnTrackny是一个全国认可的模型 CSC处理。 OnTrackny提供协调的，基于团队的服务，并展示了 症状，功能，住院和工作/学校参与的改善。快速上升 Covid-19对医疗保健系统造成了冲击，行为迅速变化 在没有证据或经验指导的情况下，包括远程医疗在内的卫生服务提供。这是 尚不清楚这些变化将如何影响和交付精神病护理和客户结果。 负责培训和实施支持的中介组织OnTrack Central OnTrackny程序，创建了用于多级利益相关者参与的系统，这是一个集中的数据 用于改进计划保真度的质量改进和评估的收集协议，以及支持的机制 基于练习的研究。我们对Ontrackny网络的日常参与揭示了最近的变化 正在极大地影响CSC服务。 2019年，Ontrackny在早期精神病干预网络（Epinet）中被授予枢纽。 推进学习医疗保健系统（LHS）。 OnTrackny站点的广度以及OnTrack Central 监督提供了一个机会，可以检查纽约州Covid-19危机的影响。这 整个州的23个OnTrackny团队的多样性使得对具有较高的环境进行检查 以及共同19感染以及各种监管和劳动力环境的流行率低。这 OnTrackny网络包括在可变法规（社区门诊诊所的门诊）中运行的程序 城市，郊区和农村的机构，国家经营的设施以及社区和学术医院 区域），参与者人数非常多样。 该项目将研究修改对onTrackny LHS中服务交付的含义 期间和之后的19危机危机。我们将使用实施科学框架，框架 报告改编和修改增强（框架）系统评估所做的修改 并确定它们的影响。我们将利用综合混合方法，包括定性访谈和重点 与利益相关者（州和地方一级的客户，家庭，提供者和决策者）的团体 Ontrackny计划数据的分析项目旨在评估：1）政府和 代理级别的政策变化以及这些决策如何影响团队人员配备和运作； 2）对 交付CSC服务； 3）对客户级护理流程的影响（例如服务利用）和 结果。目的是制定CSC模型适应指南，该指南将是忠诚度的，并且 与一致的参与度，服务利用或有利的护理结果相关。