Comprehensive Approach in Dissemination of Evidence-Based Care for PTSD.

摘要

The purpose of this study was to pilot test practice improvement approaches for management of PTSD in military behavioral health treatment settings. This project also targeted depression and alcohol use problems, which are highly comorbid with PTSD. Key evidence-based assessment and treatment recommendations for the Management of PTSD from the US Departments of Veterans Affairs and Defense (VA/DoD) Clinical Practice Guideline and other major practice guidelines were extracted. The PTSD Checklist-Civilian Version(PCL-C), the 9-item Patient Health Questionnaire (PHQ-9), and AUDIT-C were selected as screening and severity monitoring tools for PTSD, depression, and alcohol use problems, respectively. Performance Improvement in Practice (PIP) tools to inform evidence-based assessment and management for PTSD, depression, substance use problems, and for suicide risk assessment have been published, to provide evidence-based resources to facilitate practice evaluation and identification of potential gaps in care. In order to implement evidence-based management of PTSD, depression, and alcohol use problems in military behavioral health clinics, APIRE teamed up with the staff of Workflow Division, Office of the Chief Information Officer, Air Force Medical Support Agency, and clinical staff at a select practice site to arrive at a practical clinical workflow that is responsive to the needs of the clinicians. The principal charge of the Workflow Division was to improve AHLTA usability. In APIRE s collaboration with the Workflow Division, the PCL-C, PHQ-9 and AUDIT-C were methodically incorporated into AHLTA through detailed clinical workflow analyses to support severity monitoring for PTSD, depression and alcohol use, as a routine part of clinical care. The integration of abovementioned measures into enhanced AHLTA and implementation of standardized clinical workflow across the project site.