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一项针对专科精神卫生保健中结局测量临床应用的全国质量改进协作研究:平行组设计和嵌套整群随机对照试验的结果

A National Quality Improvement Collaborative for the clinical use of outcome measurement in specialised mental healthcare: results from a parallel group design and a nested cluster randomised controlled trial.

作者信息

Metz Margot J, Veerbeek Marjolein A, Franx Gerdien C, van der Feltz-Cornelis Christina M, de Beurs Edwin, Beekman Aartjan T F

机构信息

, MSc, GGz Breburg, Tilburg, The Netherlands; Trimbos Institute, Utrecht, The Netherlands; VU University, Amsterdam, The Netherlands.

, PhD, Trimbos Institute, Utrecht, The Netherlands.

出版信息

BJPsych Open. 2017 May 1;3(3):106-112. doi: 10.1192/bjpo.bp.116.004366. eCollection 2017 May.

Abstract

BACKGROUND

Although the importance and advantages of measurement-based care in mental healthcare are well established, implementation in daily practice is complex and far from optimal.

AIMS

To accelerate the implementation of outcome measurement in routine clinical practice, a government-sponsored National Quality Improvement Collaborative was initiated in Dutch-specialised mental healthcare.

METHOD

To investigate the effects of this initiative, we combined a matched-pair parallel group design (21 teams) with a cluster randomised controlled trial (RCT) (6 teams). At the beginning and end, the primary outcome 'actual use and perceived clinical utility of outcome measurement' was assessed.

RESULTS

In both designs, intervention teams demonstrated a significant higher level of implementation of outcome measurement than control teams. Overall effects were large (parallel group =0.99; RCT =1.25).

CONCLUSIONS

The National Collaborative successfully improved the use of outcome measurement in routine clinical practice.

DECLARATION OF INTEREST

None.

COPYRIGHT AND USAGE

© The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

摘要

背景

尽管基于测量的护理在精神卫生保健中的重要性和优势已得到充分确立,但在日常实践中的实施却很复杂,远未达到最佳状态。

目的

为了加速在常规临床实践中实施结果测量,荷兰专业精神卫生保健领域发起了一项由政府资助的全国质量改进协作项目。

方法

为了调查该项目的效果,我们将配对平行组设计(21个团队)与整群随机对照试验(RCT)(6个团队)相结合。在开始和结束时,评估主要结果“结果测量的实际使用情况和感知临床效用”。

结果

在两种设计中,干预组团队在结果测量的实施水平上均显著高于对照组团队。总体效果显著(平行组=0.99;RCT=1.25)。

结论

全国协作项目成功地改善了常规临床实践中结果测量的使用情况。

利益声明

无。

版权和使用

©英国皇家精神科医学院2017年。这是一篇开放获取文章,根据知识共享非商业性、禁止演绎(CC BY-NC-ND)许可协议分发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c3f/5410407/36a39b47da92/bjporcpsych004366-g001.jpg

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