tailieunhanh - Toward a policy ecology of implementation of evidence-based practices in public mental health settings

Ramesh Raghavan*1, Charlotte Lyn Bright2 and Amy L Shadoin3 Address: 1George Warren Brown School of Social Work, and Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA, 2George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA and 3Social Metrics, Inc., Huntsville, AL, USA Email: Ramesh Raghavan* - raghavan@; Charlotte Lyn Bright - clbright@; Amy L Shadoin - amy@ * Corresponding author Published: 16 May 2008 Implementation Science 2008, 3:26 doi: Received: 17 October 2007 Accepted: 16 May 2008 This article is available from: © 2008 Raghavan et al; licensee BioMed. | Implementation Science BioMed Central Open Access Debate Toward a policy ecology of implementation of evidence-based practices in public mental health settings Ramesh Raghavan 1 Charlotte Lyn Bright2 and Amy L Shadoin3 Address 1George Warren Brown School of Social Work and Department of Psychiatry School of Medicine Washington University in St. Louis St. Louis MO USA 2George Warren Brown School of Social Work Washington University in St. Louis St. Louis MO USA and 3Social Metrics Inc. Huntsville AL USA Email Ramesh Raghavan - raghavan@ Charlotte Lyn Bright - clbright@ Amy L Shadoin - amy@ Corresponding author Published 16 May 2008 Received 17 October 2007 Implementation Science 2008 3 26 doi l748-5908-3-26 Accepted 16 May 2008 This article is available from http content 3 1 26 2008 Raghavan et al licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License http licenses by which permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited. Abstract Background Mental health policymaking to support the implementation of evidence-based practices EBPs largely has been directed toward clinicians. However implementation is known to be dependent upon a broader ecology of service delivery. Hence focusing exclusively on individual clinicians as targets of implementation is unlikely to result in sustainable and widespread implementation of EBPs. Discussion Policymaking that is informed by the implementation literature requires that policymakers deploy strategies across multiple levels of the ecology of implementation. At the organizational level policies are needed to resource the added marginal costs of EBPs and to assist organizational learning by re-engineering continuing education units. At the payor and regulatory levels policies are needed to .

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