Measuring Patient Well-Being During Whole-Person Clinical Care: Lessons From the Veterans Health Administration Well-Beings Signs Implementation Pilot.

Autor:	Etingen B; Research and Development Service, Dallas VA Medical Center, Dallas, TX.; Peter O'Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, TX., Cohen-Bearak A; Center for Health Optimization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, Boston, MA., Adjognon OL; Center for Health Optimization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, MA., Vogt D; Center for Health Optimization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, MA.; Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, MA.; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA., Hogan TP; Peter O'Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, TX.; Center for Health Optimization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, Boston, MA., Gaj L; Center for Health Optimization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, Boston, MA., Orner MB; Center for Health Optimization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, Boston, MA., Barker AM; Center for Health Optimization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, Boston, MA., Bokhour BG; Center for Health Optimization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, Boston, MA.; Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA.
Jazyk:	angličtina
Zdroj:	Medical care [Med Care] 2024 Dec 01; Vol. 62 (12 Suppl 1), pp. S57-S64. Date of Electronic Publication: 2024 Nov 11.
DOI:	10.1097/MLR.0000000000002054
Abstrakt:	Background: Measuring patient well-being during clinical care may enhance patient-centered communication and treatment planning. The Veterans Health Administration (VHA) piloted the use of the Well-Being Signs (WBS), a self-report measure of psychosocial well-being, in clinical care. Objective: To understand early WBS implementation and health care team member experiences with its use before developing detailed support materials and finalizing the measure. Methods: We conducted a mixed-methods evaluation of the WBS implementation pilot at 4 VHA facilities, including surveys of (n=4) Whole Health (WH) leaders/clinical leads, and semi-structured interviews with (n=11) clinical leads and team members. Survey data were characterized using descriptive statistics; interview data were analyzed using rapid qualitative analysis. Results: Facilities supported WBS implementation by disseminating information to clinical team members, primarily during staff meetings (3/4 facilities), individual discussions (3/4), and email (3/4); only half provided training sessions. In interviews, some care team members expressed the need for more training on using the WBS in clinical care. Some interviewees also provided suggestions for changes to the draft measure, including response option format and question look-back period. Conclusions: Although there have been growing calls for attention to patient well-being in clinical care, our results suggest barriers to the implementation of well-being measures in this context. Findings were used to inform the development of enhanced training materials and make modifications to enhance the acceptability of the WBS to providers. Other identified barriers will need to be addressed in future implementation efforts, including bolstering leadership support and easing the added time and burden of administration. Competing Interests: The authors declare no conflicts of interest.
Databáze:	MEDLINE
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