Implementing Evidence-Based Practices for Youth in an HMO: The Roles of External Ratings and Market Share |
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Authors: | John Hamilton Eric Daleiden Sue Dopson |
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Institution: | (1) The Permanente Medical Group, 2345 Fair Oaks Boulevard, Sacramento, CA 95825, USA;(2) Kismetrics LLC, Satellite Beach, USA;(3) Rhodes Trust Professor of Organisational Behaviour, Said Business School, University of Oxford, Oxford, United Kingdom |
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Abstract: | A qualitative study of child clinicians in a non-profit HMO examined implementation of evidence-based practices (EBPs) for
anxiety and oppositional defiant disorders using interviews and focus groups with 33 clinicians (97% of participants), and
ethnography of emails and meetings. Analysis showed statistical measures of access and service—key elements of rating organizations’
“report cards”— were central in creating “pressure” making transition to EBPs difficult. EBPs were secondary to access and
service targets. “Research” and “statistics” were perceived as unrealistic, “literature” as lacking authority. Rating organizations
should include outcome and fidelity metrics to align market share pressures with children’s health. |
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