The effect of a mental hospital strike on general hospital psychiatric services

1984 ◽  
Vol 14 (4) ◽  
pp. 913-921 ◽  
Author(s):  
Ross M. G. Norman ◽  
Ashok K. Malla
Keyword(s):  
General Hospital ◽  
Suicidal Behaviour ◽  
Mental Hospital ◽  
Hospital Admissions ◽  
Occupational Status ◽  
General Hospitals ◽  
Hospital Units ◽  
Number Of Patients ◽  
Psychiatric Units ◽  
The Impact

SynopsisData collected from 6043 psychiatric in-patient records were analysed to assess the impact of a strike at a mental hospital on in-patient services in general hospital psychiatric units in St John's, Newfoundland, Canada. As a whole, during the strike general hospital units showed an increase in the number of involuntary admissions, the number of prior mental hospital admissions of patients, and indications of violent or suicidal behaviour; and a decrease in the occupational status of patients admitted and the prescription of minor tranquillizers. There was also evidence of considerable variation between general hospitals in the extent to which their admission pattern changed during the strike and the permanence of some of the strike effects. The data indicate that all patients showing violent or suicidal behaviour who would normally have been admitted to the mental hospital were treated in the general hospital units during the strike. On the other hand, a large number of patients diagnosed with schizophrenia, personality disorder or mental retardation, who normally would have been admitted to the mental hospital, apparently went without hospitalization during the strike. A substantial proportion of this latter group would usually have been admitted involuntarily.

Community Psychiatry in London. A Three-Year Analysis

1969 ◽  
Vol 115 (521) ◽  
pp. 465-474 ◽  
Author(s):  
A. J. Oldham
Keyword(s):  
World War Ii ◽  
General Hospital ◽  
Mental Hospital ◽  
Psychiatric Patients ◽  
Full Range ◽  
Admission Rate ◽  
Mental Hospitals ◽  
Hospital Units ◽  
Psychiatric Units ◽  
Hospital Patients

The decade following the end of World War II saw a progressive rise in the admission rate to mental hospitals in this country. The population of mental hospitals rose to a peak of 152,000 in England and Wales in 1954, since when there has been a steady decline. These fluctuations have been analysed by such authors as Norton (1961) and Tooth and Brooke (1961). The latter attributed the more recent decline to increased efficiency of treatment and rehabilitation, and predicted a continued fall so reducing the mental hospital patients by about 1970 that they would be covered by an allocation of 1 · 8 beds per thousand population. Maclay (1963) believed this prediction to err if anything on the conservative side and the Ministry of Health (1962) based its plans for psychiatric beds upon this ratio. In these plans the Ministry accepted the thesis that short-stay psychiatric patients should preferably be treated in general hospital units near to their homes whilst patients needing a longer hospital stay should be catered for in specialized hospitals for that purpose. The prediction in the Ministry of Health's Hospital Plan (1962) that there would be a steadily declining mental hospital population has been severely criticized by Gore and Jones (1961) but supported by Orwin and Sim (1965) in their analysis of the effects of the provision of acute general hospital psychiatric units in the Birmingham area. The importance of accurately assessing the psychiatric hospital bed needs over the next twenty years, given a full range medical and ancillary services, is vital to future planning and has been much in the author's mind when writing this paper.

Psychiatric Units in District General Hospitals and Traditional Mental Hospitals: Some Recent Evidence

1982 ◽  
Vol 140 (2) ◽  
pp. 160-165 ◽  
Author(s):  
S. Mahadevan ◽  
D. P. Forster
Keyword(s):  
Mental Health ◽  
General Hospital ◽  
Mental Hospital ◽  
Routine Data ◽  
District General Hospital ◽  
Organizational Structures ◽  
General Hospitals ◽  
Psychiatric Units ◽  
Patient Service ◽  
The Way

SummaryUsing routine data from the Mental Health Enquiry, the work of two district general hospital (DGH) units and a mental hospital was examined. There was a marked difference in the way the two DGH units operated and between the way the mental hospital worked as support hospital or as independent complete in-patient service. The operational policy practised by psychiatrists is more important than the structure of the system. It is important to establish sensitive policies for a wide variety of organizational structures.

Mental hospital and general hospital psychiatric units: a comparison of services within the same geographic area

1983 ◽  
Vol 13 (2) ◽  
pp. 431-439 ◽  
Author(s):  
Ashok K. Malla ◽  
Ross M. G. Norman
Keyword(s):  
General Hospital ◽  
Chronic Conditions ◽  
Mental Hospital ◽  
Economic Status ◽  
Geographic Area ◽  
Single Male ◽  
Hospital Units ◽  
Suicidal Attempts ◽  
Psychiatric Units

SYNOPSISA comparison was made between the characteristics of patients admitted to the only psychiatric hospital in Newfoundland, Canada, and those admitted to general hospital psychiatric units within the same area. Patients were compared on demographic characteristics, diagnosis, incidence of violence and suicidal attempts, treatment, length of stay and previous admissions. The results suggest that patients admitted to the mental hospital are more likely to be single, male, of lower socio-economic status and to suffer from more chronic conditions. There is also a higher incidence of violence among patients admitted to the mental hospital. These findings have implications for the types of changes that will be required in general hospital units if the role of mental hospitals continues to decline.

scholarly journals Biomarkers-based personalized follow-up in chronic heart failure improves patient’s outcomes and reduces care associate cost

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Antonio Leon-Justel ◽  
Jose I. Morgado Garcia-Polavieja ◽  
Ana Isabel Alvarez-Rios ◽  
Francisco Jose Caro Fernandez ◽  
Pedro Agustin Pajaro Merino ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Admissions ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Secondary Outcome ◽  
Ventricular Ejection Fraction ◽  
Number Of Patients ◽  
Ed Visits ◽  
The Impact

Abstract Background Heart failure (HF) is a major and growing medical and economic problem, with high prevalence and incidence rates worldwide. Cardiac Biomarker is emerging as a novel tool for improving management of patients with HF with a reduced left ventricular ejection fraction (HFrEF). Methods This is a before and after interventional study, that assesses the impact of a personalized follow-up procedure for HF on patient’s outcomes and care associated cost, based on a clinical model of risk stratification and personalized management according to that risk. A total of 192 patients were enrolled and studied before the intervention and again after the intervention. The primary objective was the rate of readmissions, due to a HF. Secondary outcome compared the rate of ED visits and quality of life improvement assessed by the number of patients who had reduced NYHA score. A cost-analysis was also performed on these data. Results Admission rates significantly decreased by 19.8% after the intervention (from 30.2 to 10.4), the total hospital admissions were reduced by 32 (from 78 to 46) and the total length of stay was reduced by 7 days (from 15 to 9 days). The rate of ED visits was reduced by 44% (from 64 to 20). Thirty-one percent of patients had an improved functional class score after the intervention, whereas only 7.8% got worse. The overall cost saving associated with the intervention was € 72,769 per patient (from € 201,189 to € 128,420) and €139,717.65 for the whole group over 1 year. Conclusions A personalized follow-up of HF patients led to important outcome benefits and resulted in cost savings, mainly due to the reduction of patient hospitalization readmissions and a significant reduction of care-associated costs, suggesting that greater attention should be given to this high-risk cohort to minimize the risk of hospitalization readmissions.

Development of the Madrid Stroke Programme: Milestones and Changes in Stroke Trends and Mortality from 1997 to 2017

2021 ◽  
pp. 1-6
Author(s):  
Silvia Pastor ◽  
Elena de Celis ◽  
Itsaso Losantos García ◽  
María Alonso de Leciñana ◽  
Blanca Fuentes ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Hospital Admissions ◽  
Temporal Trends ◽  
Intravenous Thrombolysis ◽  
Stroke Care ◽  
Care Organization ◽  
Stroke Units ◽  
Health Region ◽  
Number Of Patients ◽  
The Impact

<b><i>Introduction:</i></b> Stroke is a serious health problem, given it is the second leading cause of death and a major cause of disability in the European Union. Our study aimed to assess the impact of stroke care organization measures (such as the development of stroke units, implementation of a regional stroke code, and treatment with intravenous thrombolysis and mechanical thrombectomy) implemented from 1997 to 2017 on hospital admissions due to stroke and mortality attributed to stroke in the Madrid health region. <b><i>Methods:</i></b> Epidemiological data were obtained from the National Statistics Institute public website. We collected data on the number of patients discharged with a diagnosis of stroke, in-hospital mortality due to stroke and the number of inhabitants in the Madrid health region each year. We calculated rates of discharges and mortality due to stroke and the number of inhabitants per SU bed, and we analysed temporal trends in in-hospital mortality due to stroke using the Daniels test in 2 separate time periods (before and after 2011). Figures representing annual changes in these data from 1997 to 2017 were elaborated, marking stroke care organizational measures in the year they were implemented to visualize their temporal relation with changes in stroke statistics. <b><i>Results:</i></b> Hospital discharges with a diagnosis of stroke have increased from 170.3/100,000 inhabitants in 1997 to 230.23/100,000 inhabitants in 2017. However, the in-hospital mortality rate due to stroke has decreased (from 33.3 to 15.2%). A statistically significant temporal trend towards a decrease in the mortality percentage and rate was found from 1997 to 2011. <b><i>Conclusions:</i></b> Our study illustrates how measures such as the development of stroke units, implementation of a regional stroke code and treatment with intravenous thrombolysis coincide in time with a reduction in in-hospital mortality due to stroke.

The impact of an education intervention on the approach of hospital staff to patients with dementia in a Danish general hospital setting: An explanatory sequential mixed-methods study

2021 ◽  
pp. 205715852110229
Author(s):  
Annemarie Toubøl ◽  
Lene Moestrup ◽  
Katja Thomsen ◽  
Jesper Ryg ◽  
Dennis Lund Hansen ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Data Collection ◽  
General Hospital ◽  
Hospital Staff ◽  
Education Intervention ◽  
Post Intervention ◽  
Sequential Mixed Methods ◽  
Number Of Patients ◽  
The Impact ◽  
Dementia Education

The number of patients with dementia admitted to hospitals is increasing. However, the care and treatment of these patients tends to be suboptimal. A response to this is a widespread implementation of educational initiatives. Nevertheless, the effect of such initiatives is questioned. The aim of this study was to investigate the impact of a dementia education intervention by examining the self-reported outcomes of general hospital staff and exploring the staff’s experiences of these outcomes. An explanatory sequential mixed-methods design framed the study method. The quantitative data collection included repeated questionnaires: pre-intervention ( n = 849), one month post-intervention ( n = 618), and five months post-intervention ( n = 468) followed by a qualitative data collection using interviews ( n = 16). The GRAMMS guideline was followed. The integration of the quantitative and qualitative results suggests that the impact of the education intervention can be ascribed to the interdisciplinary focus, which facilitated a comprehensive commitment to creating careful solutions for patients with dementia. A prioritization of person over task seems to be assisted by an improved interdisciplinary cooperation initiated by the inclusion of all employed staff at the hospital in a dementia education intervention.

scholarly journals Coming in from the cold. From psychiatric to general hospital. The Irish experience

2006 ◽  
Vol 15 (2) ◽  
pp. 95-98
Author(s):  
Dermot Walsh
Keyword(s):  
Medical Care ◽  
General Hospital ◽  
Change Process ◽  
Mental Hospital ◽  
Psychiatric Care ◽  
System Of Care ◽  
Psychiatric Unit ◽  
General Hospitals ◽  
Hospital System ◽  
Self Sufficiency

AbstractThe metamorphosis from an extensive mental hospital system of care, rooted in a culture and tradition of self-sufficiency and isolation, to the concept and practise of delivery of psychiatric care in general hospitals is described. The obstacles, psychological and practical, to be overcome in this change process are outlined. The place of the general hospital psychiatric unit in psychiatric and general medical care is outlined. Relevant matters of design and management are briefly explored.

scholarly journals The impact of COVID-19 on elective and trauma spine service in a district general hospital

2020 ◽  
Vol 1 (6) ◽  
pp. 281-286
Author(s):  
Wajiha Zahra ◽  
Monil Karia ◽  
Daniel Rolton
Keyword(s):  
General Hospital ◽  
District General Hospital ◽  
Acute Hospital ◽  
Retrospective Data ◽  
Spine Trauma ◽  
Clinical Criteria ◽  
Time Period ◽  
Number Of Patients ◽  
Acute Hospital Admission ◽  
The Impact

Aims The aim of this paper is to describe the impact of COVID-19 on spine surgery services in a district general hospital in England in order to understand the spinal service provisions that may be required during a pandemic. Methods A prospective cohort study was undertaken between 17 March 2020 and 30 April 2020 and compared with retrospective data from same time period in 2019. We compared the number of patients requiring acute hospital admission or orthopaedic referrals and indications of referrals from our admission sheets and obtained operative data from our theatre software. Results Between 17 March to 30 April 2020, there were 48 acute spine referrals as compared to 68 acute referrals during the same time period last year. In the 2019 period, 69% (47/68) of cases referred to the on-call team presented with back pain, radiculopathy or myelopathy compared to 43% (21/48) in the 2020 period. Almost 20% (14/68) of spine referrals consisted of spine trauma as compared to 35% (17/48) this year. There were no confirmed cases of cauda equine last year during this time. Overall, 150 spine cases were carried out during this time period last year, and 261 spine elective cases were cancelled since 17 March 2020. Recommendations We recommend following steps can be helpful to deal with similar situations or new pandemics in future: 24 hours on-call spine service during the pandemic. Clinical criteria in place to prioritize urgent spinal cases. Pre-screening spine patients before elective operating. Start of separate specialist trauma list for patients needing urgent surgeries. Conclusion This paper highlights the impact of COVID-19 pandemic in a district general hospital of England. We demonstrate a decrease in hospital attendances of spine pathologies, despite an increase in emergency spine operations. Cite this article: Bone Joint Open 2020;1-6:281–286.

scholarly journals PSYCHOLOGICAL WELLBEING PERAWAT IGD RUMAH SAKIT JIWA DALAM MASA TUGAS COVID-19: STUDI FENOMENOLOGI

2021 ◽  
Vol 3 (2) ◽  
pp. 76-101
Author(s):  
Febriana Tri Kusumawati ◽  
Luky Dwiantoro ◽  
Devi Nurmalia
Keyword(s):  
Emergency Room ◽  
Mental Hospital ◽  
Health Workers ◽  
Positive Impact ◽  
Psychological Wellbeing ◽  
Hospital Emergency ◽  
Number Of Patients ◽  
The Face ◽  
Mutual Care ◽  
The Impact

The COVID-19 pandemic experienced by people around the world has resulted in an increase in the number of patients and stressors for nurses in Mental Hospital Emergency Departments, and is exacerbated by the condition of mental patients who are unable to communicate properly. The quality of patient care in the ER is determined by the availability of the 5M element where nurses as a human element in the COVID-19 pandemic situation require more attention regarding psychological wellbeing. Psychological wellbeing of good nurses will have a positive impact on nursing services in the ER mental hospital. The purpose of this study was to explore the experiences and feelings of psychologic wellbeing of Surakarta mental hospital emergency room nurses during the COVID-19 period. The research method used a qualitative design on the emergency room nurse mental hospital used Colaizzi analysis method. The results of the analysis of the participant interviews obtained seven themes, namely the meaning of psychological wellbeing (feeling happy, grateful to accept one's own condition, comfortable, useful and productive), Feelings during the COVID-19 pandemic (feelings at the beginning of the pandemic and current feelings), How to adapt during the COVID-19 pandemic. -19 (increased self-readiness, mutual care and support for fellow nurses, fulfillment of facilities and improvement of service systems), Hope for the COVID-19 pandemic (Joking freely and the pandemic will end soon and no health workers will fall), Changes experienced during the COVID-19 pandemic 19 (changes in regulations and culture in the face of a pandemic, changes in methods of studying online), experiences during work (pleasant experiences and bad experiences), families who always support carers (spouses and children and parents), and the impact of the COVID-19 pandemic ( towards others and towards family). The conclusion now is that nurses feel more comfortable and calm in carrying out their duties. The nurses had made adaptations to reduce anxiety so as to improve the psychological wellbeing status of the nurses.

scholarly journals The effect of the COVID pandemic lockdown measures on surgical emergencies: experience and lessons learned from a Greek tertiary hospital

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Emmanouil Pikoulis ◽  
Nikolaos Koliakos ◽  
Dimitrios Papaconstantinou ◽  
Nikolaos Pararas ◽  
Andreas Pikoulis ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Hospital Admissions ◽  
Motor Vehicle ◽  
Perianal Abscess ◽  
Lessons Learned ◽  
University Hospital ◽  
Tertiary Referral Center ◽  
Surgical Department ◽  
Number Of Patients ◽  
The Impact

Abstract Background The COVID-19 pandemic caused a rise in healthcare demands leading to significant restructuring of hospital emergency departments worldwide. The aim of the present study is twofold: firstly, to discern any differences in regard to reason for surgical emergency department (SED) attendance and hospital admission during the pandemic and pre-pandemic eras in Greece, and secondly, to assess the impact of the lockdown measures implemented during the pandemic on SED patient attendance. Methods Since the beginning of the COVID-19 pandemic in Greece (1 March 2020) and up to 15 December 2020, the charts of all adult patients arriving at the SED of the third surgical department of the “Attikon” University Hospital (a tertiary referral center for surgical and COVID-19 cases) were retrospectively reviewed and broken down in four periods reflecting two nationwide lockdown (period A 1/3/2020 to 30/4/2020 and period D 16/10/2020 to 15/12/2020) and two interim (period B 1/5/2020 to 15/6/2020 and period C 15/9/2020 to 30/10/2020) periods. Demographic and clinical data were compared to those obtained from the same time periods of the year 2019. Results The total number of patients attending the SED decreased by 35.9% during the pandemic (from 2839 total patients in 2019 to 1819 in 2020). During the first lockdown, there was statistically significant reduction of motor vehicle accidents (p=0.04) and torso injuries (p=0.01). Contrarily, the rate of head injuries (p<0.001) and abdominal pain (p=0.04) were significantly increased. The same effect was observed regarding the rate of hospital admissions (p=0.002), although in terms of absolute numbers, admissions remained unchanged. During the second lockdown, there was a reduction in the number of perianal abscess cases (p=0.04) and hernia-related problems (p=0.001). An increase in the rate of fall injuries was also demonstrable (p=0.02). Overall, application of the lockdown led to a significant decrease in minor (p<0.001) and torso (p=0.001) injuries. Conclusion The burden of the new COVID-19 disease has left a noticeable imprint in the function of emergency departments worldwide. In Greece, SED attendance was significantly reduced during the pandemic, an effect that was even more pronounced during the lockdown implementation; nevertheless, the overall rate of hospital admissions remained the same, denoting that patient care was not altered.

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