Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Academic Office 1; Mailstop B180; 12631 East 17th Ave, Aurora, CO, 80045, USA.
Indiana University School of Medicine, Indianapolis, IN, USA.
BMC Fam Pract. 2019 Sep 6;20(1):124. doi: 10.1186/s12875-019-1010-z.
Team-based models of care are efficacious in improving outcomes for patients with mental and physical illnesses. However, primary care clinics have been slow to adopt these models. We used iterative stakeholder engagement to develop an intervention to improve the implementation of team-based care for this complex population.
We developed the initial framework for Relational Team Development (RELATED) from a qualitative study of Primary Care Providers' (PCPs') experiences treating mental illness and a literature review of practice facilitation and psychology clinical supervision. Subsequently, we surveyed 900 Colorado PCPs to identify factors associated with PCP self-efficacy in management of mental illness and team-based care. We then conducted two focus groups for feedback on RELATED. Lastly, we convened an expert panel to refine the intervention.
We developed RELATED, a two-part intervention delivered by a practice facilitator with a background in clinical psychology. The facilitator observes PCPs during patient visits and provides individualized coaching. Next, the facilitator guides the primary care team through a practice change activity with a focus on relational team dynamics.
The iterative development of RELATED using stakeholder engagement offers a model for the development of interventions tailored to the needs of these stakeholders.
Not applicable.
以团队为基础的护理模式在改善精神和身体疾病患者的预后方面是有效的。然而，初级保健诊所采用这些模式的速度很慢。我们利用迭代式利益相关者参与来开发一种干预措施，以改善针对这一复杂人群的团队护理的实施。
我们从初级保健提供者（PCP）治疗精神疾病的定性研究和实践促进以及心理学临床监督文献综述中开发了初始的关系型团队发展（RELATED）框架。随后，我们对 900 名科罗拉多州的 PCP 进行了调查，以确定与 PCP 管理精神疾病和团队护理的自我效能感相关的因素。然后，我们进行了两次焦点小组讨论，以获得 RELATED 的反馈。最后，我们召集了一个专家小组来完善干预措施。
我们开发了 RELATED，这是一种由具有临床心理学背景的实践促进者提供的两部分干预措施。促进者在患者就诊期间观察 PCP，并提供个性化的指导。接下来，促进者引导初级保健团队通过一项以关系型团队动态为重点的实践改变活动。
使用利益相关者参与进行的 RELATED 的迭代式开发为针对这些利益相关者的需求定制干预措施的开发提供了一个模型。
不适用。
