PDF(Pubmed)
Abstract：
BACKGROUND: Mental health conditions affect one in seven young people and research suggests that current mental health services are not meeting the needs of most children and youth. Learning health systems are an approach to enhancing services through rapid, routinized cycles of continuous learning and improvement. Patient-reported outcome measures provide a key data source for learning health systems. They have also been shown to improve outcomes for patients when integrated into routine clinical care. However, implementing these measures into health systems is a challenging process. This paper describes a protocol for a formative evaluation of the implementation of patient-reported measures in a newly operational child and adolescent mental health centre in Calgary, Canada. The purpose is to optimize the collection and use of patient-reported outcome measures. Our specific objectives are to assess the implementation progress, identify barriers and facilitators to implementation, and explore patient, caregivers and clinician experiences of using these measures in routine clinical care.
METHODS: This study is a mixed-methods, formative evaluation using the Consolidated Framework for Implementation Research. Participants include patients and caregivers who have used the centre\'s services, as well as leadership, clinical and support staff at the centre. Focus groups and semi-structured interviews will be conducted to assess barriers and facilitators to the implementation and sustainability of the use of patient-reported outcome measures, as well as individuals\' experiences with using these measures within clinical care. The data generated by the patient-reported measures over the first five months of the centre\'s operation will be analyzed to understand implementation progress, as well as validity of the chosen measures for the centres\' population.
CONCLUSIONS: The findings of this evaluation will help to identify and address the factors that are affecting the successful implementation of patient-reported measures at the centre. They will inform the co-design of strategies to improve implementation with key stakeholders, which include patients, clinical staff, and leadership at the centre. To our knowledge, this is the first study of the implementation of patient-reported outcome measures in child and adolescent mental health services and our findings can be used to enhance future implementation efforts in similar settings.
METHODS: This study is a mixed-methods, formative evaluation using the Consolidated Framework for Implementation Research. Participants include patients and caregivers who have used the centre\'s services, as well as leadership, clinical and support staff at the centre. Focus groups and semi-structured interviews will be conducted to assess barriers and facilitators to the implementation and sustainability of the use of patient-reported outcome measures, as well as individuals\' experiences with using these measures within clinical care. The data generated by the patient-reported measures over the first five months of the centre\'s operation will be analyzed to understand implementation progress, as well as validity of the chosen measures for the centres\' population.
CONCLUSIONS: The findings of this evaluation will help to identify and address the factors that are affecting the successful implementation of patient-reported measures at the centre. They will inform the co-design of strategies to improve implementation with key stakeholders, which include patients, clinical staff, and leadership at the centre. To our knowledge, this is the first study of the implementation of patient-reported outcome measures in child and adolescent mental health services and our findings can be used to enhance future implementation efforts in similar settings.
摘要：
背景：心理健康状况影响七分之一的年轻人，研究表明，当前的心理健康服务无法满足大多数儿童和青年的需求。学习卫生系统是通过快速，持续学习和改进的程序化循环。患者报告的结果指标为学习卫生系统提供了关键数据源。当纳入常规临床护理中时，它们还被证明可以改善患者的预后。然而,在卫生系统中实施这些措施是一个具有挑战性的过程。本文介绍了在卡尔加里新运营的儿童和青少年心理健康中心实施患者报告措施的形成性评估方案，加拿大。目的是优化患者报告结果指标的收集和使用。我们的具体目标是评估实施进度,确定实施的障碍和促进者，探索病人，护理人员和临床医生在常规临床护理中使用这些措施的经验。
方法：本研究是一种混合方法，使用实施研究综合框架进行形成性评价。参与者包括使用过中心服务的患者和护理人员，以及领导力,中心的临床和支持人员。将进行焦点小组和半结构化访谈，以评估患者报告结果措施的实施和可持续性的障碍和促进者，以及个人在临床护理中使用这些措施的经验。在中心运作的头五个月，病人报告的措施产生的数据将被分析，以了解实施进展，以及为中心人口选择的措施的有效性。
结论：本次评估的结果将有助于确定和解决影响中心成功实施患者报告措施的因素。他们将为共同设计战略提供信息，以改善与主要利益相关者的实施情况，其中包括患者，临床工作人员,在中心的领导。据我们所知,这是第一项在儿童和青少年精神卫生服务中实施患者报告结局措施的研究,我们的研究结果可用于加强今后在类似环境中的实施工作.
方法：本研究是一种混合方法，使用实施研究综合框架进行形成性评价。参与者包括使用过中心服务的患者和护理人员，以及领导力,中心的临床和支持人员。将进行焦点小组和半结构化访谈，以评估患者报告结果措施的实施和可持续性的障碍和促进者，以及个人在临床护理中使用这些措施的经验。在中心运作的头五个月，病人报告的措施产生的数据将被分析，以了解实施进展，以及为中心人口选择的措施的有效性。
结论：本次评估的结果将有助于确定和解决影响中心成功实施患者报告措施的因素。他们将为共同设计战略提供信息，以改善与主要利益相关者的实施情况，其中包括患者，临床工作人员,在中心的领导。据我们所知,这是第一项在儿童和青少年精神卫生服务中实施患者报告结局措施的研究,我们的研究结果可用于加强今后在类似环境中的实施工作.
