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Measurement-based care implementation in a Veterans Affairs primary care-mental health integration program.
Psychological Services ( IF 3.097 ) Pub Date : 2020-08-01 , DOI: 10.1037/ser0000370
Daniel A Goldstein 1 , Katherine Meyers 1 , Maurice Endsley 1 , Erin O Zerth 1
Affiliation  

Measurement-based care (MBC) in behavioral health is the systematic use of validated measurement tools to guide clinical decision making and collaborative treatment planning. Although benefits of MBC for clinicians and patients have been supported by research, it appears to be underutilized in clinical settings. This study examined the effectiveness of a MBC implementation plan informed by the theory of planned behavior in a large, integrated primary care program at a Veterans Affairs hospital over 18 months. Multiple methods, including self-report clinician data and aggregated clinic data, were used to examine change in clinician MBC-related behaviors over time. Results demonstrated both an increase in symptom measures administered per clinical encounter and per individual patient treated. Additionally, the ratio of individuals receiving at least one symptom rating measure to total number of patients treated decreased over time, demonstrating increased use of MBC by integrated primary care clinicians. Survey data demonstrated upward trends in administering measures at initial assessment and at treatment termination, and clinician attitudes toward MBC were generally positive. Results corroborate the theory of planned behavior as a model in which to guide systematic MBC implementation. MBC implementation challenges and recommendations are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

中文翻译:

退伍军人事务初级护理-心理健康整合计划中基于度量的护理实施。

行为健康中的基于度量的护理(MBC)是系统地使用经过验证的度量工具来指导临床决策和协作治疗计划。尽管MBC对临床医生和患者的益处已得到研究的支持,但在临床环境中似乎未得到充分利用。这项研究以退伍军人事务医院的大型综合初级保健计划为基础,在超过18个月的时间里,通过计划行为理论检验了MBC实施计划的有效性。多种方法,包括自我报告的临床医生数据和汇总的临床数据,被用来检查随时间变化的临床医生MBC相关行为的变化。结果表明,每次临床遭遇和每位接受治疗的患者所采取的症状措施均增加。另外,随着时间的流逝,接受至少一种症状评定量度的个体与所治疗患者总数的比率下降,表明综合初级保健临床医生对MBC的使用增加。调查数据表明,在初始评估和治疗终止时,管理措施呈上升趋势,临床医生对MBC的态度总体上是积极的。结果证实了计划行为理论作为指导系统MBC实施的模型。讨论了MBC实施的挑战和建议。(PsycINFO数据库记录(c)2019 APA,保留所有权利)。调查数据表明,在初始评估和治疗终止时,管理措施呈上升趋势,临床医生对MBC的态度总体上是积极的。结果证实了计划行为理论作为指导系统MBC实施的模型。讨论了MBC实施的挑战和建议。(PsycINFO数据库记录(c)2019 APA,保留所有权利)。调查数据表明,在初始评估和治疗终止时,管理措施呈上升趋势,临床医生对MBC的态度总体上是积极的。结果证实了计划行为理论作为指导系统MBC实施的模型。讨论了MBC实施的挑战和建议。(PsycINFO数据库记录(c)2019 APA,保留所有权利)。
更新日期:2020-08-01
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