Hovmand Peter S, Gillespie David F
George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO 63130, USA.
J Behav Health Serv Res. 2010 Jan;37(1):79-94. doi: 10.1007/s11414-008-9154-y. Epub 2008 Dec 16.
Administrators of mental health services may expect evidence-based practice (EBP) to offer strategic benefits. Existing theory suggests that the benefits of implementing EBP vary by organizational characteristics. This paper presents a conceptual framework for considering how implementation impacts organizational performance. The framework is developed as a system dynamics simulation model based on existing literature, organizational theory, and key informant interviews with mental health services administrators and clinical directors. Results from the simulations show how gains in performance depended on organizations' initial inertia and initial efficiency and that only the most efficient organizations may see benefits in organizational performance from implementing EBP. Implications for administrators, policy makers, and services researchers are discussed.
心理健康服务管理人员可能期望循证实践（EBP）能带来战略效益。现有理论表明，实施循证实践的效益因组织特征而异。本文提出了一个概念框架，用于思考实施过程如何影响组织绩效。该框架是基于现有文献、组织理论以及对心理健康服务管理人员和临床主任的关键信息访谈，开发出的一个系统动力学模拟模型。模拟结果显示了绩效提升如何取决于组织的初始惯性和初始效率，并且只有效率最高的组织在实施循证实践后可能在组织绩效方面看到效益。文中还讨论了对管理人员、政策制定者和服务研究人员的启示。
