Dissemination & Training Division, National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA, USA.
Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
J Behav Health Serv Res. 2020 Oct;47(4):449-463. doi: 10.1007/s11414-020-09696-3.
A proof-of-concept practice-based implementation network was developed in the US Departments of Veteran Affairs (VA) and Defense to increase the speed of implementation of mental health practices, derive lessons learned prior to larger-scale implementation, and facilitate organizational learning. One hundred thirty-four clinicians in 18 VA clinics received brief training in the use of the PTSD checklist (PCL) in clinical care. Two implementation strategies, external facilitation and technical assistance, were used to encourage the use of outcomes data to inform treatment decisions and increase discussion of results with patients. There were mixed results for changes in the frequency of PCL administration, but consistent increases in clinician use of data and incorporation into the treatment process via discussion. Programs and clinicians were successfully recruited to participate in a 2-year initiative, suggesting the feasibility of using this organizational structure to facilitate the implementation of new practices in treatment systems.
在美国退伍军人事务部（VA）和国防部，建立了一个概念验证实践实施网络，以加快心理健康实践的实施速度，在更大规模实施之前吸取经验教训，并促进组织学习。在 18 个 VA 诊所的 134 名临床医生接受了在临床护理中使用创伤后应激障碍检查表（PCL）的简短培训。使用了两种实施策略，外部促进和技术援助，鼓励使用结果数据来为治疗决策提供信息，并增加与患者讨论结果。PCL 管理频率的变化结果喜忧参半，但临床医生越来越多地使用数据并通过讨论将其纳入治疗过程。成功招募了计划和临床医生参与为期两年的计划，这表明使用这种组织结构来促进治疗系统中新实践的实施是可行的。
