Wolk Courtney Benjamin, Stewart Rebecca E, Cronholm Peter, Eiraldi Ricardo, Salas Eduardo, Mandell David S
1Center for Mental Health Policy and Services Research, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Floor 3, Philadelphia, PA 19104 USA.
2Department of Family Medicine and Community Health and Center for Public Health Initiatives, University of Pennsylvania, 51 North 39th Street, 6th Floor Mutch Bld, Philadelphia, PA 19104 USA.
Pilot Feasibility Stud. 2019 Dec 17;5:148. doi: 10.1186/s40814-019-0529-z. eCollection 2019.
School mental health care often is provided by teams contracted from community mental health agencies. The team members that provide this care, however, do not typically receive training in how to work effectively in a team-based context. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) provides a promising, evidence-based strategy for improving communication and climate in school-based teams.
In collaboration with stakeholders, we adapted and piloted TeamSTEPPS for use with school mental health teams. Teams in six schools were randomized to receive the adapted TeamSTEPPS approach or usual supports. The main outcomes of interest were feasibility and acceptability of the adapted TeamSTEPPS strategy.
Results indicated that team member burnout was significantly higher at follow-up than pretreatment for both control and intervention teams. TeamSTEPPS was feasible and acceptable to implement, and leadership emerged as an important facilitator. Barriers to implementation success included staff turnover, lack of resources, and challenges in the school mental health team relationship. Additional supports to implement TeamSTEPPS were suggested, including ongoing consultation and booster training to address high staff turnover.
Results suggest that TeamSTEPPS is promising for school mental health teams but additional modifications are likely needed.
学校心理健康护理通常由从社区心理健康机构签约的团队提供。然而,提供这种护理的团队成员通常没有接受过如何在基于团队的环境中有效工作的培训。团队策略与工具提升绩效和患者安全(TeamSTEPPS)为改善学校团队中的沟通和氛围提供了一种有前景的、基于证据的策略。
我们与利益相关者合作,对TeamSTEPPS进行改编并在学校心理健康团队中进行试点。六所学校的团队被随机分配接受改编后的TeamSTEPPS方法或常规支持。感兴趣的主要结果是改编后的TeamSTEPPS策略的可行性和可接受性。
结果表明,在随访时,对照组和干预组团队成员的倦怠程度均显著高于治疗前。TeamSTEPPS的实施是可行且可接受的,领导力成为一个重要的促进因素。实施成功的障碍包括人员流动、资源短缺以及学校心理健康团队关系方面的挑战。建议为实施TeamSTEPPS提供额外支持,包括持续咨询和强化培训以应对高人员流动率。
结果表明,TeamSTEPPS对学校心理健康团队有前景,但可能还需要进一步修改。