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.

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.

The Italian Rare Cancer Network.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 10053-10053 ◽  
Author(s):  
Roberta Sanfilippo ◽  
Marco Tricomi ◽  
Federica Grosso ◽  
Giacomo Baldi ◽  
Beatrice De Troia ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Clinical Research ◽  
Observational Studies ◽  
Specific Treatment ◽  
Rare Cancer ◽  
Web Resource ◽  
Rare Cancers ◽  
Cancer Network ◽  
Clinical Cases

10053 Background: Rare cancers (RC) are a challenge in terms of quality of care, access to health resources and clinical research. The Italian Rare Cancer Network (RTR: “Rete Tumori Rari”) is a clinical collaborative effort to improve quality of care in adult rare solid cancers in Italy. RTR enables institutions to share clinical cases and to rationalize access to distant reference centers minimizing patient migration. It indirectly promotes collaborative clinical research by encouraging accrual into clinical trials and supporting observational studies. Methods: RTR includes 150 oncology institutions across Italy. Clinical cases are shared asynchronously over a secure Web resource. Data, images and transactions are stored in an online clinical record. Patients are shared: 1. "logically”, when they are dealt with following common clinical practice guidelines; 2. "virtually”, when they are discussed over the network between two or more centers; 3: "physically", when they are referred to an excellence center for a specific treatment modality. Pathology review is arranged through transferal of paraffin-embedded specimens and upload of consultations. While it was chosen not to implement telepathology facilities, a teleradiology resource is now available. Results: From 2003 to 2011, more than 5,000 rare cancers cases (mostly sarcomas) have been uploaded. More than 1,300 teleconsultations have been delivered, while more than 1,000 patients moved across the network during their experience of disease. 700 cases were reviewed pathologically: amongst 365 cases originally diagnosed as soft tissues sarcomas up to 2010, treatment-relevant discordances were recorded in more than one third. An observational prospective study on gastrointestinal stromal tumors was done, enrolling 800 patients. An original paper documenting the activity of a drug in a highly specific sarcoma subgroup was published. Conclusions: Clinical asynchronous online collaboration on RC is feasible through a Web-based secure environment and proved the most practical way of clinical distant sharing. Pathologic review was a crucial network service, with a special added value in RC. Retrospective and prospective observational studies, and unplanned observations in very rare cases, were an interesting by-product.

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.

Sexual behavior in psychiatric patients: a review

2015 ◽  
Vol 3 (3) ◽  
pp. 529-540
Author(s):  
Twana A Rahim ◽  
Keyword(s):  
Sexual Behavior ◽  
Quality Of Care ◽  
Psychiatric Patients ◽  
Collaborative Work ◽  
Consultation Rate

The objective of this study is to determine the rates and predictors of consulting faith healers by patients with schizophrenia, and therapeutic rituals practiced by therapists in Najaf province/Iraq. 70 patients, aged 18 year and older who attended the psychiatric out-patient unit in Najaf were invited to assess their previous contacts with faith healers. Our data demonstrated that prior faith healers consultation rate was 80%. Being younger, less formally educated, married, and female was significantly associated with faith healers consultation. Fourteen types of religious therapeutic rituals were identified. We concluded that faith healers consultation is popular and accessible among patients with schizophrenia in Iraq. Some rituals are harmful. Collaborative work with faith healers is recommended for a better quality of care.

International Association of Gerontology and Geriatrics: A Global Agenda for Clinical Research and Quality of Care in Nursing Homes

2011 ◽  
Vol 12 (3) ◽  
pp. 184-189 ◽  
Author(s):  
Debbie Tolson ◽  
Yves Rolland ◽  
Sandrine Andrieu ◽  
Jean-Pierre Aquino ◽  
John Beard ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Nursing Homes ◽  
Clinical Research ◽  
International Association ◽  
Global Agenda

scholarly journals Outcomes research shifting the dominant research paradigm in physical therapy

1997 ◽  
Vol 53 (2) ◽  
pp. 4-9
Author(s):  
Alan M. Jette
Keyword(s):  
Quality Of Care ◽  
Clinical Practice ◽  
Physical Therapy ◽  
Clinical Research ◽  
Clinical Outcomes ◽  
Outcomes Research ◽  
Direct Impact ◽  
Research Paradigm ◽  
Care Assessment

This article discusses outcomes research in physical therapy and places its conceptual roots within the work on quality-of-care assessment. An argument is advanced that the outcomes research movement in medicine has stimulated clinical researchers in physical therapy to address disability outcomes in addition to traditional impairment outcomes. If physical therapy clinical research moves beyond this broadening of clinical outcomes to investigate explicitly the hypothesized relationship between impairment and disability, outcomes research will have stimulated a shift in the dominant research paradigm in the profession. The development and testing of theory regarding the pathogenesis of disability will be needed to guide the direction of this type of physical therapy research. Such a shift in the dominant research paradigm in physical therapy could produce dramatic findings that have direct impact on clinical practice.

scholarly journals Cost Analysis of Two Methods for Improving the Quality of Care (Qoc) Scores in Paediatric Hospital Wards During Winter Periods

2015 ◽  
Vol 18 (7) ◽  
pp. A596-A597 ◽  
Author(s):  
B Standaert ◽  
X Li ◽  
D Strens ◽  
N Schecroun ◽  
M Raes
Keyword(s):  
Quality Of Care ◽  
Cost Analysis ◽  
Paediatric Hospital ◽  
Hospital Wards

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.

Chemical Restraint

1987 ◽  
Vol 32 (1) ◽  
pp. 20-21 ◽  
Author(s):  
M.S. Rapp
Keyword(s):  
Quality Of Care ◽  
Prospective Study ◽  
Psychiatric Patients ◽  
Treatment Unit ◽  
Chemical Restraint ◽  
Admission Ward ◽  
Legal Implications ◽  
Drug Doses ◽  
A Prospective Study

There are clinical and medico-legal implications to the forced administration of neuroleptic medication to actively resisting, aggressive psychiatric patients. However, there is little information on how frequently this occurs. This survey of its incidence on an acute admission ward demonstrates that “chemical restraint” as defined, is uncommon, considering the characteristics of this patient population. It is nearly always a response to threatened or actual violence towards others. The survey discovered, unexpectedly, that there were considerable differences in the actual measures used and in drug doses used during the event, between two wards of the same treatment unit. A prospective study might correlate the different patterns with degree of success, as well as address other questions, the resolution of which would lead to better quality of care.

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