The Permanente Medical Group, Sacramento, CA 95825, USA.
Adm Policy Ment Health. 2011 May;38(3):203-10. doi: 10.1007/s10488-011-0343-2.
A qualitative study of child clinicians in a non-profit HMO examined implementation of evidence-based practices (EBPs) for anxiety and oppositional defiant disorders using interviews and focus groups with 33 clinicians (97% of participants), and ethnography of emails and meetings. Analysis showed statistical measures of access and service-key elements of rating organizations' "report cards"- were central in creating "pressure" making transition to EBPs difficult. EBPs were secondary to access and service targets. "Research" and "statistics" were perceived as unrealistic, "literature" as lacking authority. Rating organizations should include outcome and fidelity metrics to align market share pressures with children's health.
一项对非营利性 HMO 中的儿童临床医生的定性研究，使用访谈和焦点小组对 33 名临床医生（97%的参与者）进行了调查，研究了实施焦虑和对立违抗性障碍的循证实践 (EBP)。分析表明，获取和服务的统计指标——评级组织“报告卡”的关键要素——在创造“压力”方面发挥了核心作用，使得向 EBP 过渡变得困难。EBP 次于获取和服务目标。“研究”和“统计”被认为不切实际，“文献”被认为缺乏权威性。评级组织应包括结果和保真度指标，以使市场份额压力与儿童健康保持一致。
