Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
J Gen Intern Med. 2021 Feb;36(2):500-505. doi: 10.1007/s11606-020-06137-x. Epub 2020 Aug 31.
Many of the most pressing health issues in the USA and worldwide require complex, multi-faceted solutions. Delivery of such solutions is often complicated by the need to reach and engage vulnerable populations facing multiple barriers to care. While the fields of quality improvement and implementation science have made valuable gains in the development and spread of individual strategies to improve evidence-based practice delivery, models for coordinated deployment of numerous strategies to simultaneously implement multiple evidence-based interventions in vulnerable populations are lacking. In this Perspective, we describe a model for this type of comprehensive research-practice translation effort: the Johns Hopkins ALACRITY Center for Health and Longevity in Mental Illness, which is focused on reducing premature mortality in the population with serious mental illness. We describe the Center's conceptual framework, which is built upon an integrated set of quality improvement and implementation science frameworks, provide an overview of the Center's organizational structure and core research-practice translation activities, and discuss our vision for how the Center may evolve over time. Lessons learned from this Center's efforts could inform models to address other critical health issues in vulnerable populations that require multi-component solutions at the policy, system, provider, and patient levels.
许多美国和全球范围内最紧迫的健康问题都需要复杂的、多方面的解决方案。由于需要接触和吸引面临多种护理障碍的弱势群体，提供这些解决方案往往变得复杂。尽管质量改进和实施科学领域在开发和传播改善基于证据的实践提供的个别策略方面取得了有价值的进展，但缺乏协调部署众多策略以同时在弱势群体中实施多种基于证据的干预措施的模型。在本观点中，我们描述了一种用于这种综合研究-实践转化工作的模型：约翰霍普金斯 ALACRITY 精神疾病健康与长寿中心，该中心专注于减少严重精神疾病人群的过早死亡率。我们描述了该中心的概念框架，该框架建立在一套综合的质量改进和实施科学框架之上，概述了该中心的组织结构和核心研究-实践转化活动，并讨论了我们对该中心如何随时间演变的设想。该中心工作中吸取的经验教训可以为需要在政策、系统、提供者和患者层面采取多组成分解决方案的弱势人群中的其他关键健康问题提供模型。
