Department of Psychiatry and Behavioral Sciences.
Department of Psychiatry and Biobehavioral Sciences.
Psychol Serv. 2020 Aug;17(3):311-322. doi: 10.1037/ser0000383. Epub 2019 Aug 12.
Ongoing and comprehensive assessment is a critical part of the implementation of evidence-based care; yet, most providers fail to routinely incorporate measurement into their clinical practice. Few studies have focused on the complex application of routine assessment or measurement-based care (MBC) with children. This pilot examined the acceptability, appropriateness, adoptability, and feasibility of an MBC effort, the Clinical Improvement through Measurement Initiative (CIMI), across several child-serving settings (e.g., community mental health center, residential treatment facility). CIMI includes a comprehensive mental health assessment protocol and combines a mobile technology platform with implementation support. Survey and focus group information, assessing implementation constructs and outcomes, was collected from 44 clinicians and staff. Overall, participants agreed that the implementation process and technology were acceptable, appropriate, and feasible for use in child mental health and that CIMI can be used to guide case conceptualization, facilitate treatment planning, and monitor outcomes. Strategies that supported the implementation process were identified as were recommendations to enhance adoption. Significant differences were observed by Community versus Specialized settings with respect to feasibility and appropriateness, likely because of factors associated with inner setting (climate, compatibility), outer setting (patient needs), and the phase of implementation achieved by sites. Implications and recommendations for tailoring MBC implementation by characteristics related to setting are discussed. MBC across child service settings are discussed in the context of implementation frameworks. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
持续全面的评估是实施循证护理的关键部分;然而,大多数提供者未能将测量常规纳入其临床实践中。很少有研究关注常规评估或基于测量的护理(MBC)在儿童中的复杂应用。这项试点研究考察了一种 MBC 方法,即通过测量进行临床改进倡议(CIMI),在几个儿童服务机构(例如,社区心理健康中心、住院治疗机构)中的可接受性、适当性、可采用性和可行性。CIMI 包括一个全面的心理健康评估方案,并将移动技术平台与实施支持相结合。从 44 名临床医生和工作人员那里收集了评估实施结构和结果的调查和焦点小组信息。总体而言,参与者一致认为,实施过程和技术在儿童心理健康方面是可以接受、适当和可行的,并且 CIMI 可用于指导病例概念化、促进治疗计划和监测结果。确定了支持实施过程的策略,并提出了增强采用的建议。社区与专门机构之间在可行性和适当性方面存在显著差异,这可能是由于与内部环境(氛围、兼容性)、外部环境(患者需求)以及机构实施阶段相关的因素所致。讨论了根据与设置相关的特征来调整 MBC 实施的影响和建议。在实施框架的背景下讨论了儿童服务设置中的 MBC。(PsycInfo 数据库记录(c)2020 APA,保留所有权利)。