Implementing Mental Health Screening for Adolescent Hematology and Oncology Patients: A Quality Improvement Initiative.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-10-01 Epub Date: 2024-05-06 DOI:10.1089/jayao.2023.0125

Tara Sebastian, Allison Close, Clare DeVeau, Chad Fessenden, Chi Braunreiter

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Abstract

Purpose: Adolescents and young adults (AYA) with chronic illnesses experience an increase in mental health concerns. A mental health screening (MHS) process for hematology and oncology patients was implemented in a single institution. The quality improvement project was conducted to integrate a MHS process, educate providers about the importance of mental health in this patient population, and evaluate the process. Methods: The COM-B (capability, opportunity, motivation-behavior) model for behavior change was used to inform strategic planning and Plan-Do-Study-Act (PDSA) methodologies for process improvement. Retrospective chart reviews and surveys were conducted to determine missed screening rates and providers' perceptions, knowledge, attitudes, and skills of the MHS process. Results: Of 334 eligible patient encounters, the missed screening rate was 15.0%, the overall error rate of completing the screening was 3.8%, the error rate of completing the suicide or self-harm indicator was 2.6%, and the missed medical social worker touch point was 4.8%. Conclusion: The rising rates of mental health concerns in AYA hematology and oncology patients call for streamlined MHS processes to improve the identification of patients who may need intervention and services. Processes should be tailored to workflows and available resources. Future PDSA cycles will include providing dedicated nursing education and determining the cost needed to meet the rising mental health needs of the AYA hematology and oncology population.

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为青少年血液学和肿瘤学患者实施心理健康筛查：质量改进计划。

目的：患有慢性疾病的青少年和年轻成年人（AYA）的心理健康问题日益增多。一家医疗机构针对血液病和肿瘤病人实施了心理健康筛查（MHS）流程。该质量改进项目旨在整合心理健康筛查流程，向医疗服务提供者宣传心理健康对这一患者群体的重要性，并对该流程进行评估。方法行为改变的 COM-B（能力、机会、动机-行为）模型被用来指导流程改进的战略规划和 "计划-实施-研究-行动"（PDSA）方法。通过回顾性病历审查和调查来确定漏筛率以及医疗服务提供者对 MHS 流程的看法、知识、态度和技能。结果：在 334 例符合条件的患者中，漏筛率为 15.0%，完成筛查的总体错误率为 3.8%，完成自杀或自残指标的错误率为 2.6%，错过医务社工接触点的错误率为 4.8%。结论青少年血液学和肿瘤学患者的心理健康问题发生率不断上升，这就要求简化医务社工服务流程，以更好地识别可能需要干预和服务的患者。流程应根据工作流程和可用资源进行调整。未来的 PDSA 循环将包括提供专门的护理教育和确定所需的成本，以满足青少年血液学和肿瘤学人群日益增长的心理健康需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.