Tyler Diane O, Taylor-Seehafer Margaret A, Murphy-Smith Michele
School of Nursing, The University of Texas at Austin 78701, USA.
J Public Health Manag Pract. 2004 Mar-Apr;10(2):100-8. doi: 10.1097/00124784-200403000-00003.
Implementation models, such as the national Put Prevention Into Practice program, have produced small to moderate changes in the delivery of preventive services in primary care. More recently, researchers concluded that guides and tools, such as the PPIP toolkit, are helpful, but are not sufficient to facilitate substantive change in clinical preventive practice. Successful implementation of clinical preventive services, according to the Texas Department of Health-PPIP (TDH-PPIP) initiative, involves creating or altering systems to produce change in service delivery for a specific setting. This article describes the ways in which the guidelines and instruments that were developed and refined through the collaborative efforts among public and private health systems were used to implement systems change and improve clinical preventive services at one community primary health care clinic in Texas. The process and empirical results of using the TDH-PPIP Implementation Model in the field are also presented, as well as a discussion of one-year evaluation data.
实施模式，如全国性的“将预防付诸实践”计划，已在初级保健中预防服务的提供方面产生了小到中等程度的变化。最近，研究人员得出结论，诸如PPIP工具包之类的指南和工具是有帮助的，但不足以促进临床预防实践中的实质性变革。根据德克萨斯州卫生部-“将预防付诸实践”（TDH-PPIP）倡议，成功实施临床预防服务涉及创建或改变系统，以便在特定环境中实现服务提供方面的变革。本文描述了通过公共和私营卫生系统的共同努力而制定和完善的指南及工具，是如何被用于在德克萨斯州的一家社区初级卫生保健诊所实施系统变革并改善临床预防服务的。还介绍了在该领域使用TDH-PPIP实施模式的过程和实证结果，以及对一年评估数据的讨论。
