Adoption of Innovations in Private A & D Treatment Centers

私营企业A采用创新

基本信息

批准号：
8829807
负责人：
Paul M Roman
金额：
$ 53.05万
依托单位：
UNIVERSITY OF GEORGIA
依托单位国家：
美国
项目类别：
财政年份：
1999
资助国家：
美国
起止时间：
1999-09-30 至 2017-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8829807
关键词：
AIDS/HIV problem Administrator Adopted Adoption Affect Area Attitude Behavior Buprenorphine Caring Characteristics Collection Data Data Collection Demography Drug Controls Electronic Health Record Environment Evidence based practice Evidence based treatment Federally Qualified Health Center Funding Funding Agency Growth Health Health Care Reform Health Policy Injectable Insurance Intervention Laws Leadership Measures Medicaid Medical Monitor Naltrexone Occupational Organizational Change Organizational Culture Organizational Decision Making Pattern Persons Policies Policy Maker Prevention Primary Health Care Private Sector Process Professional counselor Provider Public Health Questionnaires Research Research Design Resources Running Sampling Self-Administered Services Source Specialist Specific qualifier value Staging Statutes and Laws Substance Use Disorder Technology Transfer Telephone Testing Time Training Update Variant addiction base burnout cohort data collection methodology design environmental change federal policy follow-up high risk improved innovation longitudinal analysis organizational structure parity programs screening, brief intervention, referral, and treatment substance abuse treatment tool treatment center treatment organization treatment program trend

项目摘要

DESCRIPTION (provided by applicant): Since 1994, this research team has studied substance use disorder (SUD) treatment in a nationally representative sample of organizations as part of the National Treatment Center Study (NTCS). The first aim of the competing continuation proposal is to continue and expand longitudinal analysis of quality improvement in service delivery in privately funded programs for the treatment of SUDs (N=350). Using an onsite data collection methodology, self-administered questionnaires, and telephone follow-ups, the analyses will look in- depth at implementation, organizational adaptation to fit local circumstances, sustainability, and discontinuation of evidence-based treatment practices (EBPs) and HIV/AIDS-related services (e.g., rapid testing, prevention). The study will also investigate in-depth, the sources of dissemination that most influence organizational decision-making. We will continue measuring the managerial innovations of continuous quality improvement (CQI) and its variants, process improvement strategies and testing and intervention for HIV/AIDS, as well as updating our collection of data on organizational structure and culture, and inter-organizational relationships. The second aim is to continue and expand collection and analysis of workforce data from counselors (N=1430) and administrators (N=280). We will continue to identify and measure sources of influence on counselor and administrator attitudes toward EBPs and practices affecting implementation and adaptation of EBPs, and continue to monitor changes in demographic and professional characteristics of counselors and administrators, focusing intensely on administrators' leadership styles. An added innovation in our research design is to follow defined cohorts of counselors and administrators across the 5-year funding period to ascertain the entire range of mobility within, between, and outside SUD treatment organizations. For both groups, we will measure influence of burnout, pay and benefits, organizational culture, and opportunity on their choices to move. For administrators, we will examine the relationship between mobility and leadership style. The third Aim is to analyze the impact of two new Federal policies and other environmental changes on the organization and delivery of treatment services in privately funded SUD treatment programs. The federal parity law and forthcoming health care reform are likely to dramatically affect demand for SUDs treatment in two ways: more persons will be covered by insurance, and there will be more extensive coverage for those insured. The legislation should thus increase treatment accessibility and availability, stimulate opportunities for integration of SUD treatment into general medical practice and increase inter-organizational competition. Combinations of competition and enhanced resources may drive continuing quality improvement and EBP adoption. Depending upon the external management of these new resources, new stakeholders may emerge and alter the inter-organizational relationships required of providers of SUD treatment services. Eventually these forces should advance organizational reconfigurations through partnering, acquisitions, and mergers.

描述（由申请人提供）：自1994年以来，该研究团队在全国代表性的组织样本中研究了药物使用障碍（SUD）治疗，这是国家治疗中心研究（NTCS）的一部分。竞争性延续建议的第一个目的是继续并扩大私人资助的SUD治疗计划中服务提供质量改善的纵向分析（n = 350）。使用现场数据收集方法，自我管理的问卷和电话随访，分析将对实施，组织适应适合当地情况，可持续性以及基于证据的治疗实践（EBPS）（EBPS）和HIV/AIDS相关服务（例如，迅速测试，预测）的组织适应。这项研究还将深入研究，即最大的传播来源，这些传播来源影响组织决策。我们将继续衡量持续质量改进（CQI）及其变体，过程改进策略以及艾滋病毒/艾滋病的测试和干预的管理创新，并更新我们有关组织结构和文化的数据收集以及组织间关系。第二个目的是继续从辅导员（n = 1430）和管理员（n = 280）的劳动力数据收集和分析。我们将继续识别和衡量对辅导员和管理员对影响EBP实施和适应的实践的影响的影响来源，并继续监视辅导员和管理人员的人口统计和专业特征的变化，重点关注管理人员的领导风格。在我们的研究设计中，另一项创新是遵循5年资金期间界定的辅导员和管理人员的同类群体，以确定内部，外部和外部SUD治疗组织内部，内部和外部的移动性范围。对于这两个小组，我们将衡量倦怠，薪水和利益，组织文化以及机会对他们的选择的影响。对于管理员来说，我们将研究流动性与领导风格之间的关系。第三个目的是分析两项新的联邦政策以及其他环境变化对私人资助的SUD治疗计划中的组织和提供服务服务的影响。联邦平价法和即将进行的医疗保健改革可能会以两种方式极大地影响对SUDS治疗的需求：更多的人将被保险覆盖，并且被保险人将更加广泛的承保范围。因此，立法应提高治疗可及性和可用性，刺激将SUD治疗整合到一般医学实践中并增加组织间竞争的机会。竞争和增强资源的组合可能会推动持续的质量改进和EBP采用。根据这些新资源的外部管理，新的利益相关者可能会出现并改变SUD治疗服务提供者所需的组织间关系。最终，这些力量应通过合作，收购和合并来推动组织重新配置。