Using NIATx Strategies to Implement Integrated Services in Routine Care
使用 NIATx 策略在日常护理中实施综合服务
基本信息
- 批准号:9275460
- 负责人:
- 金额:$ 55.17万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2015
- 资助国家:美国
- 起止时间:2015-09-30 至 2020-05-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAlcohol or Other Drugs useAlcoholsAwarenessClinicalClinical ManagementClinical ServicesCommunitiesComplexControl GroupsCost AnalysisCountyDataDiagnosisDimensionsDrug Use DisorderDrug abuseEconomicsEffectivenessEngineeringEvaluationEvidence based interventionFDA approvedFutureGoalsHIVHealth PersonnelHealth Services AccessibilityHealth systemHealthcareIndividualIndustrializationInformation ManagementInterdisciplinary StudyInterventionMeasurableMeasuresMedicalMental disordersMethodologyModelingNamesOutcomeOutpatientsPathway interactionsPatient CarePatient-Focused OutcomesPatientsPenetrationPersonsPharmaceutical PreparationsPhasePlant RootsProceduresProtocols documentationProviderPsychiatric Social WorkQuality of CareRandomizedRecoveryResearchResearch PersonnelResourcesSamplingSelf ManagementServicesSeveritiesTaxonomyTestingUniversitiesVariantWaiting ListsWashingtonWisconsinaddictionbasebehavioral healthcare systemscohortcomparativecostdesigndual diagnosisethnographic methodevidence baseexperienceexperimental studyfollow-uphealth care availabilityhealth care deliveryhealth care serviceheuristicsimplementation researchimplementation scienceimprovedindexingmedical schoolsmultidisciplinaryprimary outcomeprogramspublic health relevancereduce symptomsresponseroutine carescreening, brief intervention, referral, and treatmentsocial
项目摘要
DESCRIPTION (provided by applicant): The proposed implementation research addresses a longstanding and vexing problem in behavioral health care: Access to integrated services for persons with co-occurring substance use and mental health disorders. Despite decades of awareness of this problem, at present, less than 10% of treated patients with co-occurring disorders receive evidence-based integrated services. Implementation science holds to key to addressing this persistent gap. The present study unifies and operationalizes three major implementation research heuristics: the Consolidated Framework for Implementation Research, the Stages of Implementation Completion, and the Proctor et al (2011) taxonomy of implementation outcomes. Developed by industrial engineers, a multi-faceted implementation strategy, NIATx, has proven to be effective in implementing and sustaining simple interventions in behavioral health care services. The overarching goal of this project is to test whether NIATx strategies are effective in implementing a complex evidence-based intervention: Integrated services for persons with co-occurring disorders. Promising pilot data suggest that NIATx actually can integrate services, but a more rigorous study is needed. We now take this step and herein propose a cluster randomized wait-list control group design, in which a cohort of 23 agencies receive the active NIATx approach while the other cohort of 23 agencies are waitlisted. In the second phase, the wait-list group of 23 agencies participates in NIATx and the initial group enters a sustainment phase. Hypothesized to install and sustain integrated services, NIATx is examined for effectiveness on two core implementation outcomes: fidelity and penetration, as well as patient care outcomes (psychiatric and substance use symptom reduction). Variation in the extent of and fidelity to which NIATx strategies are delivered are evaluated using the NIATx Fidelity Scale, which embeds the Stages of Implementation Completion measure. Primary outcomes are assessed at pre- implementation, post-implementation and at sustainment follow-up periods. Qualitative and economic analyses augment the quantitative data, and add to the interpretation of organizational and social dynamics, as well as resource costs. We assemble a multi-disciplinary research team with considerable and complementary expertise and experience. Capitalizing on a technically sophisticated clinical management information capacity across a state system of care (Washington), the study engages representative outpatient programs across 20 counties. Consistent with US data, the participating agencies and their key stakeholders are highly motivated to improve services for patients with co-occurring disorders. Practical implementation strategies, including their associated costs, and the measurable impact on services and patient outcomes, will be definitive research products. Findings from this robust study are immediately applicable to improve clinical services, to advance implementation research, and ultimately, to guide future implementations with other behavioral health systems and settings.
描述(由申请人提供):拟议的实施研究解决了行为健康保健中一个长期存在的令人困扰的问题:为同时患有药物使用和精神健康障碍的人获得综合服务。尽管几十年来人们意识到了这个问题,但目前,接受治疗的共生疾病患者中,只有不到10%的人接受了循证综合服务。实施科学是解决这一长期差距的关键。本研究统一并实施了三个主要的执行研究试探法:执行研究综合框架、执行完成阶段和Proctor等人(2011年)对执行结果的分类。由工业工程师开发的多方面实施战略NIATx已被证明在实施和维持行为健康护理服务的简单干预方面是有效的。该项目的首要目标是测试NIATx战略在实施复杂的循证干预措施方面是否有效:为共病患者提供综合服务。前景看好的试点数据表明,NIATx实际上可以整合服务,但还需要更严格的研究。我们现在采取这一步骤,并在此提出一种整群随机等待名单控制组设计,其中23个机构的队列接受积极的NIATx方法,而另一个队列的23个机构被列入等待名单。在第二阶段,由23个机构组成的等待名单小组参加了NIATx,最初的小组进入维持阶段。NIATx被假设为安装和维持综合服务,对两个核心实施结果:保真度和渗透率以及患者护理结果(精神和药物使用症状的减少)的有效性进行了检查。NIATx战略交付的程度和忠诚度的差异使用NIATx忠诚度量表进行评估,该量表嵌入了实施完成措施的各个阶段。在实施前、实施后和维持后续阶段对初步成果进行评估。定性和经济分析增加了定量数据,并增加了对组织和社会动态以及资源成本的解释。我们组建了一支多学科的研究团队,拥有大量和互补的专业知识和经验。这项研究利用了整个州护理系统(华盛顿州)在技术上先进的临床管理信息能力,参与了20个县的代表性门诊项目。与美国的数据一致,参与机构及其主要利益相关者高度有动力改善对共生疾病患者的服务。实际的实施战略,包括其相关成本,以及对服务和患者结果的可衡量影响,将是最终的研究产品。这项稳健研究的结果立即适用于改善临床服务,推进实施研究,并最终指导未来与其他行为健康系统和环境的实施。
项目成果
期刊论文数量(0)
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James H Ford其他文献
Teaching and learning styles in quality improvement: Identification and impact on process outcomes
- DOI:
10.1186/1940-0640-10-s1-a12 - 发表时间:
2015-02-20 - 期刊:
- 影响因子:3.200
- 作者:
James H Ford;James Robinson - 通讯作者:
James Robinson
James H Ford的其他文献
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{{ truncateString('James H Ford', 18)}}的其他基金
Stagewise Implementation-To-Target- Medications for Addiction Treatment (SITT-MAT)
分阶段实施成瘾治疗目标药物 (SITT-MAT)
- 批准号:
10313995 - 财政年份:2021
- 资助金额:
$ 55.17万 - 项目类别:
Stagewise Implementation-To-Target- Medications for Addiction Treatment (SITT-MAT)
分阶段实施成瘾治疗目标药物 (SITT-MAT)
- 批准号:
10689722 - 财政年份:2021
- 资助金额:
$ 55.17万 - 项目类别:
Stagewise Implementation-To-Target- Medications for Addiction Treatment (SITT-MAT)
分阶段实施成瘾治疗目标药物 (SITT-MAT)
- 批准号:
10462739 - 财政年份:2021
- 资助金额:
$ 55.17万 - 项目类别:
Sustainability of Change within a Quality Improvement Collaborative
质量改进协作中变革的可持续性
- 批准号:
8768586 - 财政年份:2014
- 资助金额:
$ 55.17万 - 项目类别:
Impact of Staff Learning and Coach Teaching Styles in Quality Improvement
员工学习和教练教学风格对质量改进的影响
- 批准号:
8664829 - 财政年份:2013
- 资助金额:
$ 55.17万 - 项目类别:
Impact of Staff Learning and Coach Teaching Styles in Quality Improvement
员工学习和教练教学风格对质量改进的影响
- 批准号:
8582300 - 财政年份:2013
- 资助金额:
$ 55.17万 - 项目类别: