miércoles, 24 de septiembre de 2014

Comment Key Questions | AHRQ Effective Health Care Program

Comment Key Questions | AHRQ Effective Health Care Program

Agency for Healthcare Research Quality

Improving Mental Health Care for Children: Deadline October 6

A set of draft key questions and background for a planned systematic evidence review of strategies for improving mental health care for children and adolescents has been posted on AHRQ’S Effective Health Care Web site. The deadline for submitting comments is October 6, 2014.   

This figure depicts the Key Questions (KQs) within the context of the populations, interventions, comparisons, outcomes, and settings (PICOTS) framework described in the previous section. The framework begins on the left with our population of interest:  health care systems, organizations, and providers who care for children and adolescents with mental health problems. A solid horizontal arrow starts from the population and extends right. Above the first part of the thick horizontal arrow is the intervention: dissemination, implementation, or quality improvement (D/I/QI) inventions. The solid horizontal arrow then leads to Intermediate Outcomes to illustrate the pathways from D/I/QI interventions to patient-, provider-, and system-level intermediate outcomes.  A dotted line leads from Intermediate Outcomes to a final box on the far right of the framework and depicts the final health outcome improvements in patients (KQ1). An overarching solid arrow connects D/I/QI to the patient outcome box on the far right to illustrate the question: for children and adolescents with mental health problems, including behavioral, substance use, and developmental disorders such as intellectual disabilities and autism spectrum disorders, what is the effectiveness of dissemination, implementation, and quality improvement (D/I/QI) interventions used in outpatient settings to improve patient outcomes (KQ 1)? As illustrated by the solid vertical arrow below the D/I/QI intervention box, interventions may result in harms (KQ 2). To illustrate whether patient, provider, or intervention characteristics, contextual factors, or settings modify the effectiveness or harms of D/I/QI mental health interventions (KQ 3), from the modifiers of effectiveness or harms box, three dotted arrows branch to the solid arrows between D/I/QI and harms, D/I/QI and intermediate outcomes, and D/I/QI and patient outcome and a fourth dotted arrow branches to the dotted arrow between intermediate outcomes and patient outcome.

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