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评估退伍军人事务部预防自杀预测分析模型在当地实施后的临床医生态度。

Evaluating Clinician Attitudes After Local Implementation of the Veterans Affairs Predictive Analytic Model for Suicide Prevention.

出版信息

J Psychiatr Pract. 2022 Jan 6;28(1):14-23. doi: 10.1097/PRA.0000000000000595.

Abstract

OBJECTIVE

The Recovery Engagement and Coordination for Health-Veterans Enhanced Treatment (REACH VET) program was launched in 2017 to identify Veterans at high risk for suicide and other adverse outcomes using predictive analytics. This quality improvement study evaluated the sustainment of the REACH VET program at a large Veterans Affairs health care system by assessing clinician attitudes.

METHODS

A mixed-methods approach was used to collect anonymous survey (N=35) and qualitative interview (n=12) data from Veterans Affairs REACH VET providers.

RESULTS

Survey findings demonstrated largely neutral to negative attitudes towards REACH VET, with the most notable responses indicating that REACH VET identified Veterans who were already perceived to be engaged in care. Interview findings reflected a variety of attitudes, including perceived lack of added value and pessimism regarding successful outreach. Clinicians reported that the program was values-consistent and had the potential to improve the quality of care.

CONCLUSIONS

Results demonstrate the need for educational interventions and improved communication between local coordinators and clinicians. Clinicians rarely discussed fears about the algorithmic approach, but they highlighted concerns about the value that this approach added to their role. Future evaluations are needed to examine additional sustainment issues.

摘要

目的

REACH VET 计划于 2017 年启动,旨在利用预测分析技术确定有自杀和其他不良后果风险的退伍军人。本质量改进研究通过评估临床医生的态度,评估了大型退伍军人事务医疗保健系统中 REACH VET 计划的持续情况。

方法

采用混合方法从退伍军人事务 REACH VET 提供者处收集匿名调查(N=35)和定性访谈(n=12)数据。

结果

调查结果表明,对 REACH VET 的态度大多为中性或负面,最引人注目的反应表明,REACH VET 确定了已经被认为参与护理的退伍军人。访谈结果反映了各种态度,包括对增加价值的感知不足以及对成功外展的悲观情绪。临床医生报告说,该计划符合价值观,并有可能提高护理质量。

结论

结果表明需要进行教育干预,并改善当地协调员和临床医生之间的沟通。临床医生很少讨论对算法方法的担忧,但他们强调了对这种方法对其角色增加的价值的担忧。需要进一步评估未来的可持续性问题。

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