背景:由于症状波动和异质性,新兴成年人的精神疾病通常难以改善。最近,已经开发了创新的方法来改善新兴成年人的精神保健,包括(1)实施患者报告的结果措施(PROMs),以评估疾病的严重程度,并告知分层护理,以指定新兴的成年人与他们的损害程度相称的治疗模式,以及(2)实施快速学习的卫生系统,其中数据不断收集和分析,以产生新的见解,然后转化为临床实践,包括客户之间的合作,卫生保健提供者,和研究人员共同设计和评估评估和治疗策略。
目的:研究的目的是确定实施快速学习健康系统的可行性和可接受性,新兴成人的分层护理治疗策略。
方法:本研究在卡尔加里一家为新兴成年人(16-24岁)服务的专业诊所进行,加拿大,涉及研究人员之间的广泛合作,提供者,和青春。研究设计包括六个阶段:(1)开发用于PROM的诊断平台,(2)设计初始分层护理模型,(3)将PROM的实施与分层护理相结合,(4)评估结果并传播结果,(5)根据来自PROM的数据修改分层护理,(6)向新站点的传播和规模。在整个实施过程中,将从医疗保健提供者和青年那里收集定性和定量反馈。这些数据将定期进行分析,并用于修改未来服务的交付方式。TheRE-AIM(Reach,有效性,收养,实施,和维护)框架用于根据3个关键目标组织和评估实施:改善治疗选择,减少平均等待时间和治疗持续时间,提高服务的价值。
结果:该项目由2021年至2026年的计划拨款资助。这项研究的伦理批准于2023年2月获得。目前,我们已经开发了一个PROM系统,并将临床服务组织到护理层。我们将很快开始使用PROM将客户分配到护理层,并使用青年和临床医生的反馈来了解如何改善经验和结果。
结论:这项研究对研究人员和临床医生有重要意义,希望了解如何定制新兴的成人心理健康服务,以提高护理质量和护理满意度。作为基于价值的医疗保健运动的一部分,这项研究对精神卫生保健系统具有重要意义。
■PRR1-10.2196/51667。
BACKGROUND: Mental illness among emerging adults is often difficult to ameliorate due to fluctuating symptoms and heterogeneity. Recently, innovative approaches have been developed to improve mental health care for emerging adults, including (1) implementing patient-reported outcome measures (PROMs) to assess illness severity and inform stratified care to assign emerging adults to a treatment modality commensurate with their level of impairment and (2) implementing a rapid learning health system in which data are continuously collected and analyzed to generate new insights, which are then translated to clinical practice, including collaboration among clients, health care providers, and researchers to co-design and coevaluate assessment and treatment strategies.
OBJECTIVE: The aim of the study is to determine the feasibility and acceptability of implementing a rapid learning health system to enable a measurement-based, stratified care treatment strategy for emerging adults.
METHODS: This study takes place at a specialty clinic serving emerging adults (age 16-24 years) in Calgary, Canada, and involves extensive collaboration among researchers, providers, and youth. The study design includes six phases: (1) developing a transdiagnostic platform for PROMs, (2) designing an initial stratified care model, (3) combining the implementation of PROMs with stratified care, (4) evaluating outcomes and disseminating results, (5) modification of stratified care based on data derived from PROMs, and (6) spread and scale to new sites. Qualitative and quantitative feedback will be collected from health care providers and youth throughout the implementation process. These data will be analyzed at regular intervals and used to modify the way future services are delivered. The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework is used to organize and evaluate implementation according to 3 key objectives: improving treatment selection, reducing average wait time and treatment duration, and increasing the value of services.
RESULTS: This project was funded through a program grant running from 2021 to 2026. Ethics approval for this study was received in February 2023. Presently, we have developed a system of PROMs and organized clinical services into strata of care. We will soon begin using PROMs to assign clients to a stratum of care and using feedback from youth and clinicians to understand how to improve experiences and outcomes.
CONCLUSIONS: This study has key implications for researchers and clinicians looking to understand how to customize emerging adult mental health services to improve the quality of care and satisfaction with care. This study has significant implications for mental health care systems as part of a movement toward value-based health care.
UNASSIGNED: PRR1-10.2196/51667.