The Experts below are selected from a list of 412746 Experts worldwide ranked by ideXlab platform
Bradley E Karlin - One of the best experts on this subject based on the ideXlab platform.
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from the laboratory to the therapy room national dissemination and implementation of evidence based psychotherapies in the u s department of veterans affairs Health Care System
American Psychologist, 2014Co-Authors: Bradley E Karlin, Gerald CrossAbstract:Despite their established efficacy and recommendation--often as first-line treatments--in clinical practice guidelines, evidence-based psychotherapies (EBPs) have largely failed to make their way into mainstream clinical settings. Numerous attempts over the years to promote the translation of EBPs from science to practice, typically relying on one-dimensional dissemination approaches, have yielded limited success. As part of the transformation of its mental Health Care System, the Veterans Health Administration (VHA) of the U.S. Department of Veterans Affairs (VA) is working to disseminate and implement a number of EBPs for various mental and behavioral Health conditions throughout the VA Health Care System. This article examines VHA's multidimensional model and specific strategies, involving policy, provider, local Systems, patient, and accountability levels, for promoting the national dissemination and implementation of EBPs in VHA. In addition, the article identifies key lessons learned and next steps for further promoting EBP delivery and sustainability in the VA Health Care System. Beyond promoting the availability of effective treatments for veterans returning from Iraq and Afghanistan and for veterans of previous combat eras, VHA's EBP dissemination and implementation model and key lessons learned may help to inform other private and public Health Care Systems interested in disseminating and implementing EBPs.
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national dissemination of cognitive behavioral therapy for depression in the department of veterans affairs Health Care System therapist and patient level outcomes
Journal of Consulting and Clinical Psychology, 2012Co-Authors: Bradley E Karlin, Antonette M Zeiss, Gregory K Brown, Mickey Trockel, Darby Cunning, Barr C TaylorAbstract:OBJECTIVE The Department of Veterans Affairs (VA) Health Care System is nationally disseminating and implementing cognitive behavioral therapy for depression (CBT-D). The current article evaluates therapist and patient-level outcomes associated with national training in and implementation of CBT-D in the VA Health Care System. METHOD Therapist competencies were assessed with the Cognitive Therapy Rating Scale (CTRS). Patient outcomes were assessed with the Beck Depression Inventory-II and the World Health Organization Quality of Life-BREF. Therapeutic alliance was assessed with the Working Alliance Inventory-Short Revised. Two-hundred twenty-one therapists have received training, and 356 veteran patients have received treatment through the VA CBT-D Training Program. RESULTS Of therapists who have participated in the program, 182 (82%) completed all training requirements and achieved competency, reflected by a score of 40 on the CTRS. Of 356 patients, nearly 70% completed 10 or more sessions or improved sufficiently to stop therapy before the 10th session. Mean depression scores decreased by approximately 40% from initial to later treatment phase. Effect sizes of changes ranged from d = 0.39 to d = 0.74 for quality of life and from d = 0.47 to d = 0.66 for therapeutic alliance measures. CONCLUSION National training in and implementation of CBT-D within the VA Health Care System is associated with significant, positive therapist training outcomes, as evidenced by increases in CBT core competencies. The implementation of the protocol by newly trained CBT-D therapists is associated with significantly improved patient outcomes, as evidenced by large decreases in depression and improvements in quality of life.
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integrating mental Health and primary Care services in the department of veterans affairs Health Care System
Journal of Clinical Psychology in Medical Settings, 2008Co-Authors: Antonette M Zeiss, Bradley E KarlinAbstract:Integrating mental Health Care in the primary Care setting has been identified in the literature as a model for increasing access to mental Health services and has been associated with enhanced clinical and functional patient outcomes and higher patient satisfaction. The Department of Veterans Affairs (VA), which operates the nation’s largest integrated Health Care System, has taken a leadership role in creating a Health Care System in which mental Health Care is provided in the primary Care setting. This article examines VA’s efforts and progress to date in implementing evidence-based models of integrated mental Health services nationally in community based outpatient clinics, home based primary Care, and outpatient primary clinics at medical facilities. Psychology plays an important role in this progress, as part of an overall interdisciplinary effort, in which all professions are crucially important and work together to promote the overall well-being of patients.
Peter T. Sawicki - One of the best experts on this subject based on the ideXlab platform.
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the german Health Care System in international comparison the primary Care physicians perspective
Deutsches Arzteblatt International, 2011Co-Authors: Klaus Koch, Antje Miksch, Christoph Schurmann, Stefanie Joos, Peter T. SawickiAbstract:The importance of primary Health Care has been and continues to be debated because of the recent reforms to the German Health Care System. Although national and international policies aim to strengthen primary Care, it is feared, particularly in Germany, that the tasks of the primary Care physician are increasingly considered unattractive and consequently fewer physicians are focusing on primary Care. It therefore stands to reason to ask primary Care physicians and other physicians providing primary Health Care directly about their perceptions of the Health Care System. In 1999 the Commonwealth Fund (CWF) initiated a project to determine the quality of Health Care from various perspectives, including from the point of view of primary Care physicians (1– 9). By 2004, surveys had been conducted in Australia (AUS), Canada (CDN), New Zealand (NZ), the United States (USA), and the United Kingdom (UK). Germany (D) participated in the study for the first time in 2005, and primary Care physicians were surveyed in 2006 (10, 11). These surveys revealed that German primary Care physicians reported by far the greatest number of patient contacts paired with the shortest period of contact. At the same time, German primary Care physicians expressed the highest level of dissatisfaction with their Health Care System. In 2009, primary Care physicians were again asked to assess their work and the Health Care System in an international comparison. Schoen et al. summarized the international data (12). In the present article we describe selected results for Germany in specific areas and, where possible, compare them with the results from 2006 (10). The participants in the 2009 survey were asked about the following aspects: general satisfaction with the Health Care System perceived quality of the Care provided opportunities for patients to access primary Health Care scheduling appointments and treatment outside consulting hours support for chronic diseases, encouraging self-management, coordination of treatment use of computer technologies for administration and documentation opportunities to improve quality and to upgrade specific competencies use of clinical information Systems experience with financial incentive Systems to improve quality, performance, and coordination of Care factors that prevent or encourage high-quality Care.
Gerald Cross - One of the best experts on this subject based on the ideXlab platform.
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from the laboratory to the therapy room national dissemination and implementation of evidence based psychotherapies in the u s department of veterans affairs Health Care System
American Psychologist, 2014Co-Authors: Bradley E Karlin, Gerald CrossAbstract:Despite their established efficacy and recommendation--often as first-line treatments--in clinical practice guidelines, evidence-based psychotherapies (EBPs) have largely failed to make their way into mainstream clinical settings. Numerous attempts over the years to promote the translation of EBPs from science to practice, typically relying on one-dimensional dissemination approaches, have yielded limited success. As part of the transformation of its mental Health Care System, the Veterans Health Administration (VHA) of the U.S. Department of Veterans Affairs (VA) is working to disseminate and implement a number of EBPs for various mental and behavioral Health conditions throughout the VA Health Care System. This article examines VHA's multidimensional model and specific strategies, involving policy, provider, local Systems, patient, and accountability levels, for promoting the national dissemination and implementation of EBPs in VHA. In addition, the article identifies key lessons learned and next steps for further promoting EBP delivery and sustainability in the VA Health Care System. Beyond promoting the availability of effective treatments for veterans returning from Iraq and Afghanistan and for veterans of previous combat eras, VHA's EBP dissemination and implementation model and key lessons learned may help to inform other private and public Health Care Systems interested in disseminating and implementing EBPs.
Paul A Heidenreich - One of the best experts on this subject based on the ideXlab platform.
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divergent trends in survival and readmission following a hospitalization for heart failure in the veterans affairs Health Care System 2002 to 2006
Journal of the American College of Cardiology, 2010Co-Authors: Paul A Heidenreich, Anju Sahay, John R Kapoor, Michael X Pham, Barry M MassieAbstract:Objectives This study sought to determine recent trends over time in heart failure hospitalization, patient characteristics, treatment, rehospitalization, and mortality within the Veterans Affairs Health Care System. Background Use of recommended therapies for heart failure has increased in the U.S. However, it is unclear to what extent hospitalization rates and the associated mortality have improved. Methods We compared rates of hospitalization for heart failure, 30-day rehospitalization for heart failure, and 30-day mortality following discharge from 2002 to 2006 in the Veterans Affairs Health Care System. Odds ratios for outcome were adjusted for patient diagnoses within the past year, laboratory data, and for clustering of patients within hospitals. Results We identified 50,125 patients with a first hospitalization for heart failure from 2002 to 2006. Mean age did not change (70 years), but increases were noted for most comorbidities (mean Charlson score increased from 1.72 to 1.89, p Conclusions Recent mortality and rehospitalization rates in the Veterans Affairs Health Care System have trended in opposite directions. These results have implications for using rehospitalization as a measure of quality of Care.
Sara R Collins - One of the best experts on this subject based on the ideXlab platform.
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covid 19 implications for the Health Care System
The New England Journal of Medicine, 2020Co-Authors: David Blumenthal, Elizabeth J Fowler, Melinda K Abrams, Sara R CollinsAbstract:Covid-19 — Implications for the Health Care System The Covid-19 pandemic has exposed and exacerbated weaknesses in the U.S. Health Care System. Many patients are losing their Health insurance when ...
