A new unit for long-stay psychiatric patients: organization, attitudes and quality of care

1984 ◽  
Vol 14 (1) ◽  
pp. 183-192 ◽  
Author(s):  
P. A. Garety ◽  
I. Morris
Keyword(s):  
Decision Making ◽  
Quality Of Care ◽  
Organizational Structure ◽  
Management Practices ◽  
Psychiatric Patients ◽  
Positive Interactions ◽  
Staff Attitudes ◽  
Chronic Patients ◽  
Residential Unit

SynopsisThe present study describes and evaluates aspects of care in a new residential unit for chronic patients. The findings suggest that the unit is relatively resident-orientated in its management practices and that the staff are similarly orientated in their attitudes. Staff also hold generally optimistic attitudes to residents' potential accomplishments and consider themselves highly involved in decision-making. They also show high levels of positive interactions with the residents. Various aspects of staff attitudes and behaviour are positively correlated with seniority or length of time on the unit. The results are discussed in terms of the unit's organizational structure and its possible impact on residents' functioning.

Participation in Clinical Trials May Improve Care of Acute Schizophrenia Inpatients in a General Hospital

CNS Spectrums ◽  
2008 ◽  
Vol 13 (9) ◽  
pp. 757-761 ◽  
Author(s):  
Uriel Halbreich ◽  
Nancy Smail ◽  
Xin Tu ◽  
Judith Halbreich
Keyword(s):  
Quality Of Care ◽  
Clinical Research ◽  
Psychiatric Patients ◽  
Diagnostic Interview ◽  
Physical Restraints ◽  
Double Blind ◽  
Acute Schizophrenia ◽  
Hospital Wards ◽  
Study Inclusion

AbstractIntroduction: This report demonstrates parameters of quality of care and treatment outcome of acute schizophrenia patients who were involved as subjects in a clinical trial of two marketed widely used antipsychotics compared with their fellow patients who received routine clinical hospital care.Methods: Patients were newly admitted severely agitated schizophrenia patients who agreed to participate in a double-blind randomized trial of short-term (5 days) rate of improvement in response to two second-generation oral antipsychotics. Treatment outcomes as measured by the Clinical Global Impression and parameters of quality of care were compared with the general population of inpatients in the same county hospital.Results: Of 145 patients screened, 109 patients did not meet study inclusion and exclusion criteria. It is of note that systematic diagnostic interview did not confirm the clinical diagnosis of schizophrenia in 17 patients (11.7%). Study patients had shorter length of stay (6.75 days vs 15.3 days of total psychiatric patients at the hospital during the study period), no physical restraints (vs 21.9%), no use of antipsychotics as chemical restraints (vs 19.8%), and less recidivism following the trial (28.1%) compared with prior to the trial (64.3%).Conclusion: Patients who participate in structured clinical research with well-delineated procedures, clinical outcome measures, and clear expectations, faired better than their fellow patients in the same non-research hospital wards. Application of some characteristics of clinical research to the diagnosis and treatment of clinical non-research patients may be considered.

scholarly journals Quality of care transition and its association with hospital readmission

Aquichan ◽  
2020 ◽  
Vol 19 (4) ◽  
pp. 1-11
Author(s):  
Luciana Andressa Feil Weber ◽  
Maria Alice Dias da Silva Lima ◽  
Aline Marques Acosta
Keyword(s):  
Quality Of Care ◽  
Chronic Diseases ◽  
Hospital Readmission ◽  
Care Transition ◽  
Chronic Patients ◽  
Cross Sectional ◽  
Hospital Management System ◽  
Student’S T ◽  
Inpatient Units

Objective: To evaluate the quality of care transition for patients with chronic diseases and to verify its association with hospital readmission within 30 days after discharge. Method: Cross-sectional epidemiological study of 210 patients with chronic diseases discharged from a hospital in southern Brazil. The Care Transition Measure-15 (CTM-15) instrument was used, through a telephone contact and, in order to identify readmissions within 30 days, the hospital management system was consulted. Student’s t-tests analysis of variance and nonparametric Pearson or Spearman correlation tests were performed. Results: CTM-15 score was 74.7 (± 17.1). No significant association was found between the quality of care transition and hospital readmission. 12.3 % of the patients were readmitted, and 46.2 % of these readmissions were to the emergency service. Conclusions: The quality of the care transition for chronic patients from inpatient units to home, showed a satisfactory score. However, there was no association between the quality of care transition and hospital readmission within 30 days after discharge.

Residential Care in Hospital and in the Community – Quality of Care and Quality of Life

1996 ◽  
Vol 168 (4) ◽  
pp. 448-456 ◽  
Author(s):  
Geoff Shepherd ◽  
Matt Muijen ◽  
Rachel Dean ◽  
Margaret Cooney
Keyword(s):  
Quality Of Life ◽  
Quality Of Care ◽  
Management Practices ◽  
Housing Association ◽  
Cross Sectional ◽  
Living Situation ◽  
Internal Management ◽  
External Management ◽  
Hospital Wards

BackgroundThe reduction of beds in long-stay hospitals has led to concerns over the quality of care offered to the remaining residents as well as that provided in the community. This study seeks to compare the quality of care and quality of life (reported satisfaction) from residents in both types of setting.MethodA cross-sectional comparison was made of community residential homes and hospital wards drawn randomly from lists provided by local authorities in the outer London area. Samples were drawn from all the main provider types (local authority, housing association, private and joint NHS/voluntary sector). Measures were taken of the quality of the physical environment, staff and resident characteristics, external management arrangements and internal management regimes, resident satisfaction and staff stress. Direct observations were also made of the amount and quality of staff-resident interactions.ResultsIn general, the most disabled residents were found to be still living in hospital in the worst conditions and receiving the poorest quality of care. Although there were some problems with missing data, hospital residents also seemed most dissatisfied with their living situation. There were few differences between community providers regarding either the quality of care provided or the levels of reported satisfaction. Quality of care in the community homes seemed to be much more determined by the personality and orientation of project leaders.ConclusionsPurchasers and providers still need to give attention to the problems of selectively discharging the most able residents to the community, leaving the most disabled being looked after in progressively deteriorating conditions. All residential providers need to review their internal management practices and try to ensure that residents are offered, as far as possible, the opportunity to make basic choices about where and how they will live. Staff training and quality assurance practices need to be reviewed in order to improve the direct quality of care offered to the most disabled individuals.

scholarly journals 3200 Balancing Cost and Quality of Care in the US and Denmark: Lessons for Nations Transitioning from Volume-Based to Value-Based Care

2019 ◽  
Vol 3 (s1) ◽  
pp. 140-140
Author(s):  
Negin Fouladi ◽  
Margit Malmmose
Keyword(s):  
Decision Making ◽  
Quality Of Care ◽  
Control Strategies ◽  
Decision Makers ◽  
Sources Of Information ◽  
Healthcare Organizations ◽  
Regulatory Oversight ◽  
Physician Practices ◽  
The Us

OBJECTIVES/SPECIFIC AIMS: Promote knowledge translation and evidence-informed decision-making by assessing barriers and facilitators to balancing cost and quality of care within the US state of Maryland and nation of Denmark. METHODS/STUDY POPULATION: Open-ended and semi-structured key-informant interviews were conducted in 2016 and 2017 among high level decision-makers in Maryland (N=21) and the Danish (N=17) healthcare systems, including hospital, local, regional, and cross-organizational administrators and elected officials. The interviews consisted of questions related to: (1) currently practiced and preferred approaches to resource allocation and development and use of quality performance measures, and (2) preferred sources, formats/styles, modes of information, and decision-making strategies based on a shift from volume to quality-driven care. RESULTS/ANTICIPATED RESULTS: Decision-makers in Maryland expressed the need for collaboration in a changing environment, yet increasingly rely on cost and quality outcomes data to drive decisions and note the struggle to identify credible and useful information. Maryland decision-makers also face challenges in regulating utilization and costs without mandated participation of physician practices within the global budget cap model, which is perceived to be a primary driver of healthcare utilization in the hospital sector. Similarly, decision-makers in Denmark conveyed the importance of quantitative data to aid decisions, however, stress collaboration and dialogue as driving factors and important sources of information. Danish decision-makers also express challenges to wide-spread adoption of a quality-driven approach due to unsustained quality assurance regulatory bodies. DISCUSSION/SIGNIFICANCE OF IMPACT: The findings suggest implementation of value-based healthcare is highly driven and influenced by availability of credible data, which may significantly impact development of policies and innovative cost control strategies, and regulatory oversight to promote adoption of quality measures in decision-making. Furthermore, collaboration within and across healthcare organizations remains a key component to health system improvement as it fosters dialogue and sharing of best practices among stakeholders.

Community and hospital residential care: a comparative evaluation

1997 ◽  
Vol 14 (3) ◽  
pp. 92-98 ◽  
Author(s):  
Jerome Carson ◽  
Deborah Cullen ◽  
Frank Holloway ◽  
Aisling Towey ◽  
Angela Jumbo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Quality Of Care ◽  
Residential Care ◽  
Comparative Evaluation ◽  
Management Practices ◽  
Community Hospital ◽  
Life Experiences ◽  
Service Systems ◽  
Psychological View

AbstractObjective: To compare the quality of care offered by a community hospital hostel and three hospital rehabilitation facilities (two traditional rehabilitation wards and an innovative normalisation unit) for people with longterm mental illnesses.Method: Quality of care is assessed here on three different levels: those of Input using Programme Analysis of Service Systems; Assessment of Care Environments; Process using Ward Management Practices Questionnaire; Attitudes to Treatment Questionnaire; Outcome using Rehabilitation Evaluation Hall and Baker and the Life Experiences Checklist and resident and staff questionnaires. These measures cover a range of perspectives from staff to residents, and include both standardised assessments as well as specific schedules developed for the study.Results: On Input measures, the community hospital hostel had the best scores on the Programme Analysis of Service Systems schedule, which measures the degree to which services meet predetermined normalisation criteria. On the Assessment of Care Environments it also scored favourably against other community facilities. Process measures showed no differences between units in terms of their management practices, all scoring well, but suggested some differences in staff attitudes. Staff in the community hospital hostel had the most medical approach to care, however this was accounted for by the scores of untrained staff. Qualified nurses had a more psychological approach to care. Finally on Output measures, residents in the community hospital hostel were found to be the most disabled on the REHAB scale. Despite this, they had a significantly better quality of life as assessed by the Life Experiences Checklist. Staff in the community hospital hostel had the clearest perceptions of their roles, though there were differences again in how qualified and unqualified staff perceived their work. Residents were generally satisfied with services, though residents in the community hospital hostel and in the hospital normalisation unit had the highest satisfaction levels.Conclusion: The results of this comparative evaluation show that a high standard of care, equal to or surpassing some of the best hospital provision, can be provided in the community. This is despite the fact that the residents in the community hospital hostel were more disabled. Community patients' quality of life is better in a number of domains than their hospital counterparts and even patients initially reticent about the move into the community report higher levels of satisfaction, especially regarding their home environment. There-were interesting differences between trained and unqualified staff in the community hospital hostel. Trained staff had a more psychological view of patient care and felt more supported and appreciated by the team than their untrained colleagues. The implications of these findings for community residential care are discussed.

scholarly journals Using appreciative inquiry to implement person-centred dementia care in hospital wards

Dementia ◽  
2016 ◽  
Vol 18 (1) ◽  
pp. 190-209 ◽  
Author(s):  
Anthony Scerri ◽  
Anthea Innes ◽  
Charles Scerri
Keyword(s):  
Quality Of Care ◽  
Appreciative Inquiry ◽  
Dementia Care ◽  
Professional Collaboration ◽  
Staff Attitudes ◽  
Action Plans ◽  
Paper Report ◽  
Inquiry Approach ◽  
Hospital Wards

The quality of care of persons with dementia in hospitals is not optimal and can be challenging. Moreover, staff may find difficulty in translating what they have learned during training into practice. This paper report the development and evaluation of a set of workshops using an appreciative inquiry approach to implement person-centred dementia care in two hospital wards. Staff worked collaboratively to develop a ward vision and to implement a number of action plans. Using appreciative inquiry approach, staff attitudes towards persons with dementia improved, inter-professional collaboration was enhanced and small changes in staff practices were noted. Dementia care in hospitals can be enhanced by empowering staff to take small but concrete actions after they engage in appreciative inquiry workshops, during which they are listened to and appreciated for what they can contribute.

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