Beach Scott R, Walker Jane, Celano Christopher M, Mastromauro Carol A, Sharpe Michael, Huffman Jeff C
Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA.
Psychological Medicine Research, University of Oxford Department of Psychiatry, Oxford OX1 2JD, UK.
Gen Hosp Psychiatry. 2015 Nov-Dec;37(6):522-7. doi: 10.1016/j.genhosppsych.2015.06.015. Epub 2015 Jun 24.
Collaborative care is a systematic, team-based approach to the management of depression and other psychiatric disorders in medical settings. Collaborative care has been found to be effective and cost-effective, but there is little information to guide its implementation in clinical care. The objective of this article is to provide a practical guide to the implementation of collaborative care programs in real-world settings.
Based on our experience delivering collaborative care programs, we provide (a) specific, stepwise recommendations for the successful implementation of collaborative care in outpatient settings and (b) an examination of the additional benefits and challenges of collaborative care programs that begin during hospitalization.
The implementation of collaborative care requires senior buy-in, an effective team, clear treatment components, engaged clinicians, procedures to ensure quality and adequate infrastructure. Beginning these programs with hospitalized patients may offer additional advantages but also requires additional flexibility to adapt to the inpatient setting.
A systematic approach to the development and implementation of collaborative care programs may allow clinicians to effectively and efficiently treat psychiatric illness in medical populations in both inpatient and outpatient settings.
协作式照护是一种在医疗环境中管理抑郁症及其他精神疾病的系统性、基于团队的方法。已发现协作式照护是有效且具成本效益的，但几乎没有信息可指导其在临床护理中的实施。本文的目的是为在现实环境中实施协作式照护项目提供一份实用指南。
基于我们开展协作式照护项目的经验，我们提供（a）在门诊环境中成功实施协作式照护的具体、逐步建议，以及（b）对在住院期间启动的协作式照护项目的额外益处和挑战的审视。
协作式照护的实施需要高层支持、一个有效的团队、明确的治疗组成部分、积极参与的临床医生、确保质量的程序以及充足的基础设施。以住院患者启动这些项目可能会带来额外优势，但也需要额外的灵活性以适应住院环境。
一种开发和实施协作式照护项目的系统性方法可能使临床医生能够在住院和门诊环境中有效且高效地治疗医疗人群中的精神疾病。
