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利用“保持儿童/自己安全与保障”(KySS)项目增强门诊初级保健环境中的儿科心理健康保健:一项多学科质量改进项目。

Enhancing Pediatric Mental Health Care in an Outpatient Primary Care Setting Using the Keep Your Children/Yourself Safe and Secure (KySS) Program: A Multidisciplinary Quality Improvement Project.

出版信息

J Pediatr Health Care. 2024 Jan-Feb;38(1):5-12. doi: 10.1016/j.pedhc.2023.09.004. Epub 2023 Oct 6.

Abstract

INTRODUCTION

This project aimed to enhance access to pediatric mental primary health care.

METHOD

The Keep Your Children/Yourself Safe and Secure (KySS) training was offered to a multidisciplinary team at a Federally Qualified Health Clinic in the Midwest United States. Confidence was measured using the Healthcare Provider Confidence Scale (HPCS). Frequencies of visits and mental health referrals were compared preintervention/postintervention. HPCS scores were compared using Wilcoxon rank-sum and Cohen's d.

RESULTS

Referrals in 2022 were greater than in 2020 but less than in 2021 (p = .25). The total number of visits declined from 431 in 2021 to 385 in 2022. HPCS (n = 9) scores trended higher following the KySS Program in prescribing and general positive beliefs.

DISCUSSION

Referrals to mental health providers increased, although not significantly. The number of mental health visits varied between 2020-2022. Provider confidence was not significantly affected, whereas beliefs in prescribing did increase significantly. More work is necessary to understand the impact of delivery to a multidisciplinary team.

摘要

简介

本项目旨在增加儿童心理健康初级保健的可及性。

方法

在中西部的一家联邦合格健康诊所,为多学科团队提供了保持儿童/自己安全和保障(KySS)培训。使用医疗保健提供者信心量表(HPCS)来衡量信心。比较干预前后就诊次数和心理健康转介的频率。使用 Wilcoxon 秩和检验和 Cohen's d 比较 HPCS 评分。

结果

2022 年的转介量大于 2020 年,但小于 2021 年(p=0.25)。2021 年就诊次数为 431 次,2022 年降至 385 次。KySS 项目后,在开具处方和普遍积极信念方面,HPCS(n=9)评分呈上升趋势。

讨论

尽管没有显著增加,但转介到心理健康提供者的人数有所增加。2020-2022 年间心理健康就诊次数有所不同。提供者的信心没有显著受到影响,而在开具处方方面的信念确实显著增加。需要进一步努力了解向多学科团队提供服务的影响。

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