Staab Erin M, Terras Mara, Dave Pooja, Beckman Nancy, Shah Sachin, Vinci Lisa M, Yohanna Daniel, Laiteerapong Neda
1 University of Chicago, Chicago, IL.
Am J Med Qual. 2018 May/Jun;33(3):253-261. doi: 10.1177/1062860617736607. Epub 2017 Oct 26.
Provider- and staff-perceived levels of integration were measured during implementation of a primary care behavioral health clinic; these data were used to tailor and evaluate quality improvement strategies. Providers and staff at an urban, academic, adult primary care clinic completed the 32-item Level of Integration Measure (LIM) at baseline and 7 months. The LIM assesses 6 domains of integrated care. Overall and domain scores were calibrated from 0 to 100, with ≥80 representing a highly integrated clinic. Response rate was 79% (N = 46/58) at baseline and 83% (N = 52/63) at follow-up. Overall, LIM score increased from 64.5 to 70.1, P = .001. The lowest scoring domains at baseline were targeted for quality improvement and increased significantly: integrated clinical practice, 60.0 versus 68.4, P < .001; systems integration, 57.0 versus 63.8, P = .001; and training, 56.7 versus 65.3, P = .001. Ongoing quality improvement, including organizational and financial strategies, is needed to achieve higher levels of integration.
在一家初级保健行为健康诊所的实施过程中，对提供者和工作人员感知的整合水平进行了测量；这些数据被用于调整和评估质量改进策略。一家城市学术性成人初级保健诊所的提供者和工作人员在基线期和7个月时完成了32项整合水平测量（LIM）。LIM评估综合护理的6个领域。总体得分和领域得分的校准范围为0至100，≥80表示高度整合的诊所。基线期的回复率为79%（N = 46/58），随访时为83%（N = 52/63）。总体而言，LIM得分从64.5提高到70.1，P = .001。基线期得分最低的领域被作为质量改进的目标，且有显著提高：综合临床实践，从60.0提高到68.4，P < .001；系统整合，从57.0提高到63.8，P = .001；培训，从56.7提高到65.3，P = .001。需要持续的质量改进，包括组织和财务策略，以实现更高水平的整合。
