Introduction: People with serious mental illness (SMI) are more likely to smoke and less likely to receive tobacco treatment. Implementation strategies may address clinician and organizational barriers to treating tobacco in mental healthcare.
Methods: A cluster-randomized trial (Clinic N=13, Client N=610, Staff N=222) tested two models to promote tobacco treatment in community mental healthcare: standard didactic training vs.
Background: The implementation of evidence-based practices in critical care faces specific challenges, including intense time pressure and patient acuity. These challenges result in evidence-to-practice gaps that diminish the impact of proven-effective interventions for patients requiring intensive care unit support. Research is needed to understand and address implementation determinants in critical care settings.
View Article and Find Full Text PDFBackground: Tobacco use disorder (TUD) rates are 2-3 times higher among people with serious mental illness (SMI) than the general population. Clinicians working in outpatient community mental health clinics are well positioned to provide TUD treatment to this group, but rates of treatment provision are very low. Understanding factors associated with the provision of TUD treatment by mental health clinicians is a priority.
View Article and Find Full Text PDFInterventions for children with autism spectrum disorder are complex and often are not implemented successfully within schools. When new practices are introduced in schools, they often are layered on top of existing practices, with little attention paid to how introducing new practices affects the use of existing practices. This study evaluated how introducing a computer-assisted intervention, called TeachTown:Basics, affected the use of other evidence-based practices in autism support classrooms.
View Article and Find Full Text PDFIntroduction: Individuals with serious mental illness (SMI) smoke at rates two to three times greater than the general population but are less likely to receive treatment. Increasing our understanding of correlates of smoking cessation behaviors in this group can guide intervention development.
Aims And Methods: Baseline data from an ongoing trial involving smokers with SMI (N = 482) were used to describe smoking cessation behaviors (ie, quit attempts, quit motivation, and smoking cessation treatment) and correlates of these behaviors (ie, demographics, attitudinal and systems-related variables).
In May 2019, scholars in management and organization of health care organizations and systems met. The opening plenary was a moderated discussion with five distinguished scholars who have exemplified pushing the frontier of organizational theory and practice throughout their careers: Ann Barry Flood of Dartmouth College, John Kimberly of the University of Pennsylvania, Anthony (Tony) Kovner of New York University, Stephen (Steve) Shortell of University of California at Berkeley, and Jacqueline (Jackie) Zinn of Temple University. The discussion was moderated by Ingrid Nembhard of the University of Pennsylvania.
View Article and Find Full Text PDFIntroduction: People with mental illness are more likely to smoke and less likely to receive tobacco treatment than the general population. The Addressing Tobacco Through Organizational Change (ATTOC) approach supports organizational change to increase tobacco treatment in this population. We describe preliminary study feasibility and baseline behaviors and attitudes among clients and staff regarding tobacco treatment, and assesse correlates of treatment of smoking.
View Article and Find Full Text PDFBackground: The number of children diagnosed with autism has rapidly outpaced the capacities of many public school systems to serve them, especially under-resourced, urban school districts. The intensive nature of evidence-based autism interventions, which rely heavily on one-to-one delivery, has caused schools to turn to computer-assisted interventions (CAI). There is little evidence regarding the feasibility, effectiveness, and implementation of CAI in public schools.
View Article and Find Full Text PDFAnn N Y Acad Sci
October 2016
The world of health care is changing dramatically, as reflected in the number, magnitude, and scope of innovative new approaches-to how illness is treated and how better health is promoted-that are being implemented around the globe. The changes triggered by these initiatives affect both how care is organized, managed, and paid for and the kinds of approaches that are being developed to keep people healthy. Underlying these changes is a more fundamental paradigm shift, a shift in the priority given to "value" in the formulation of policy and management practice.
View Article and Find Full Text PDFOrganizations that provide health services are increasingly in need of systems and approaches that will enable them to be more responsive to the needs and wishes of their clients. Two recent trends, namely, patient-centered care (PCC) and personalized medicine, are first steps in the customization of care. PCC shifts the focus away from the disease to the patient.
View Article and Find Full Text PDFBackground: The introduction of evidence-based programs and practices into healthcare settings has been the subject of an increasing amount of research in recent years. While a number of studies have examined initial implementation efforts, less research has been conducted to determine what happens beyond that point. There is increasing recognition that the extent to which new programs are sustained is influenced by many different factors and that more needs to be known about just what these factors are and how they interact.
View Article and Find Full Text PDFThe pressure is on to measure performance and to increase accountability in health care in general and in addiction treatment in particular. The pressure in the world of addiction treatment comes in large measure from the limited resources that are available in relation to the very large numbers of potential patients. Using data on 161 clinics in the state of Maryland, this article illustrates how data envelopment analysis (DEA), a methodology used widely in other settings, can be used to measure the performance of addiction treatment clinics and can help to identify appropriate benchmarks for clinics wishing to improve their performance.
View Article and Find Full Text PDFJ Subst Abuse Treat
September 2008
Addiction treatment providers face serious problems in delivering consistent, high-quality services over time. Among those providers with multiple treatment sites, there is also intersite variability. This is a serious problem in the addiction field, likely to be made worse as new technologies are introduced and/or as there is industry consolidation (Corredoira, R.
View Article and Find Full Text PDFAdm Policy Ment Health
March 2008
This paper presents a brief review of organizational measures related to implementation of new practices and technologies in sectors other than mental health, and discusses potential application of these measures to mental health implementation research. A few standardized organizational measures are presented along with considerations regarding the appropriateness of adapting existing measures rather than creating novel ones or using additional methodologies. Challenges and opportunities for researchers in measuring key organizational constructs related to implementation in mental health settings are discussed.
View Article and Find Full Text PDFInnovations in health care account for some of the most dramatic improvements in population health outcomes in the developed world as well as for a nontrivial proportion of growth in expenditures. Provider organizations are the adopters of many of these innovations, and understanding the factors that inhibit or facilitate their diffusion to and possible disengagement from these organizations is important in addressing cost, quality, and access issues. Given the importance of these issues, the purpose of this article is to (1) create a comprehensive census of studies examining the adoption of and disengagement from innovations in health care provider organizations; (2) organize these studies into an inductively derived classification scheme; (3) assess the studies' strengths and weaknesses; and (4) reflect on the implications of our review for future research.
View Article and Find Full Text PDFJ Subst Abuse Treat
October 2006
Drawing on experiences in other industries, this article argues that the business of addiction treatment is likely to be transformed by the advent of a period of consolidation, in which a number of small independent programs will be acquired by larger, better capitalized, and managerially more sophisticated enterprises. Consolidation will be driven by opportunities to leverage new technologies, to exploit new regulatory initiatives, and to introduce economies of scale and scope into an industry that is currently highly fragmented. The process is likely to result in segmentation of the market, with the coexistence of large, generalist, highly standardized firms and a number of small highly specialized firms.
View Article and Find Full Text PDFThe social and economic costs of addiction are substantial and of great concern to society. Research in the past decade has led to promising therapies that appear to be highly effective but not widely diffused. This leads one to wonder if there is something about the structure, dynamics, or structure and dynamics of the addiction treatment industry that is getting in the way.
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