EVIDENCE-BASED PRACTICES FOR ALL POPULATIONS

There are evidence-based practices in clinical preventive services that should be utilized with all populations, whether or not they are receiving services related to a particular diagnosis or condition. This is an area for improvement in services to persons with severe mental illness, who historically have had difficult accessing healthcare services for acute or chronic medical conditions, not to mention clinical screening and prevention services.

The U.S. Preventive Services Task Force (USPSTF) (http://www.ahcpr.gov/clinic/uspstfix.htm) was convened by the U.S. Public Health Service to rigorously evaluate clinical research in order to assess the merits of preventive measures, including screening tests, counseling, immunizations, and chemoprevention. The USPSTF consists of 15 experts from the specialties of family medicine, pediatrics, internal medicine, obstetrics and gynecology, geriatrics, preventive medicine, public health, behavioral medicine, and nursing. The recommended clinical prevention services are organized into the following clinical categories:

The original Task Force's efforts culminated in the 1989 Guide to Clinical Preventive Services. A second edition of the Guide was published in 1996. In November 1998, the Agency for Healthcare Research and Quality (then the Agency for Health Care Policy and Research) convened the current USPSTF to update existing Task Force assessments and recommendations and to address new topics.


CONCLUSION

The Institute of Medicine's Improving the Quality of Healthcare for Mental and Substance-Use Conditions states: "A large body of research and other published work on organizational change, for example, consistently calls attention to five predominantly human resource management practices (and one other organizational practice) that are key to successful change implementation (1) ongoing communication about the desired change with those who are to effect it; (2) training in the new practice; (3) worker involvement in designing the change process; (4) sustained attention to progress in making the change; (5) use of mechanisms for measurement, feedback, and redesign; and (6) functioning as a learning organization. All of these practices require the exercise of effective leadership."