文章基本信息

标题：Complex Interventions and Interorganisational Relationships: Examining Core Implementation Components of Assertive Community Treatment
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作者：Magnus Bergmark ; Ulrika Bejerholm ; Bengt Svensson 等
期刊名称：International Journal of Integrated Care
电子版ISSN：1568-4156
出版年度：2018
卷号：18
期号：4
DOI：10.5334/ijic.3547
语种：English
出版社：Utrecht University, Maastricht University, Groningen University
摘要：Introduction: There is increasing interest in implementing evidence-based integrated models of care in community-based mental health service systems. Assertive Community Treatment (ACT) is seen as an attractive, and at the same time challenging, model to implement in sectored service settings. This study investigates the implementation process of such an initiative. Methods: Interviews were conducted with ACT team members, the process leader, steering group members, and collaboration partners. The “Sustainable Implementation Scale” helped to identify critical implementation components, and these were further explored using the qualitative interview data. The “Tool for Measuring Assertive Community Treatment” addressed programme fidelity, and the initiative’s sustainability was assessed. Results: High-fidelity implementation of ACT in a sectored service setting is possible. Prominent components that facilitated implementation were careful preparations, team members’ characteristics, and efforts by the process leader and the steering group to improve networking. Implementation was hampered by conflicting goals among the involved authorities and a mismatch between the ACT model’s characteristics and existing organisational traditions and regulations. Discussion and Conclusions: Reducing the uncertainty caused by conflicting goals is an important step in improving the implementation of ACT. In order to facilitate implementation, the goals, regulations, and availability of resources should be aligned horizontally and vertically through the involved organisations.