scholarly journals Case management and assertive community treatment. What is the difference?

2008 ◽  
Vol 17 (2) ◽  
pp. 99-105 ◽  
Author(s):  
Tom Burns
Keyword(s):  
Case Management ◽  
Assertive Community Treatment ◽  
Health Care Systems ◽  
Unintended Consequences ◽  
Community Treatment ◽  
Small Range ◽  
Bed Management ◽  
Published Evidence ◽  
Management Procedures ◽  
Care Systems

AbstractThere has been a long-running controversy about the relative benefits of Assertive Community Treatment (ACT) compared to Case Management (CM). Several health care systems have initiated major service overhauls on the basis of published evidence. Yet this evidence has been ambiguous and supports differing interpretations. Research is examined which explores the differences in outcomes reported. It uses a range of approaches, most prominently meta-regression, to test a small range of hypotheses to explain the heterogeneity in outcomes. The main determinant of differences between ACT and CM studies is the local bed management procedures and occupancy practice. Those organizational aspects of ACT which are generally shared by CM teams are associated with reduced hospital care but the stringent staffing proposed for ACT does not affect it. ACT is a specialized form of CM, not a categorically different approach. The benefits of introducing it will depend on the nature of current local practice. Important lessons about the need to focus on treatments rather than structures seem not to have been learnt. Psychiatry's recent excessive focus on service structures may have had unintended consequences for our professional identity.

scholarly journals So what shall we do about assertive community treatment?

2008 ◽  
Vol 17 (2) ◽  
pp. 110-114 ◽  
Author(s):  
Sonia Johnson
Keyword(s):  
Assertive Community Treatment ◽  
Community Care ◽  
Risk Group ◽  
Full Range ◽  
Relevant Literature ◽  
High Risk Group ◽  
Community Treatment ◽  
Admission Rates ◽  
Recovery Orientation ◽  
Care Systems

AbstractThe usefulness of Assertive Community Treatment (ACT) in European countries with well-developed community care systems has been disputed, despite considerable relevant literature. This paper aims to assess reasons for and against implementing ACT in such countries. ACT may not be useful where generic community mental health teams are not yet well-developed, where admission rates are already low, or where an alternative model based on close integration of a full range of types of care is in place. Good reasons for introducing ACT include listening to patients' preferences, being able to monitor a high risk group of patients more successfully, good staff satisfaction, and the potential for using ACT teams as a platform for delivering interventions for difficult to treat psychosis. The ACT model is more likely to thrive in future if a recovery orientation can be adopted.

Policies, bundles, and protocols in critical care

2016 ◽  
Author(s):  
Jeffrey Mazer ◽  
Mitchell M. Levy
Keyword(s):  
Patient Safety ◽  
Rapid Detection ◽  
Health Care Systems ◽  
Unintended Consequences ◽  
Evidence Based ◽  
Ample Evidence ◽  
Implementation Evaluation ◽  
Care Systems ◽  
Based Medicine ◽  
Medicine Community

Recently, the medicine community has been driven to think about patient safety in new ways, and with this new found interest in patient safety, large health care systems and individual institutions have been forced to develop mechanisms to track and measure performance. There is ample evidence that physicians and systems can do better. The tools of this new craft include checklists, protocols, guidelines, and bundles. These tools help to decrease variability in care and enhance the translation of evidence-based medicine to bedside care. Ongoing measurement of both performance and clinical outcomes is central to this movement. This allows for rapid detection of both successes and possible unintended consequences associated with the rapid translation of evidence into practice. As hospitals and intensive care units (ICU) worldwide have embraced the field of quality improvement (QI), many lessons have been learned about the process. QI includes four essential phases—development, implementation, evaluation, and maintenance. Essential to the QI process and each of these QI phases is that the project must be tailored to each individual ICU and/or Institution. A one-size-fits-all project is less efficient, less effective, and at times unnecessary compare with a locally-driven process.

Case Management and Assertive Community Treatment in Europe

2001 ◽  
Vol 52 (5) ◽  
pp. 631-636 ◽  
Author(s):  
Tom Burns ◽  
Angelo Fioritti ◽  
Frank Holloway ◽  
Ulf Malm ◽  
Wulf Rössler
Keyword(s):  
Case Management ◽  
Assertive Community Treatment ◽  
Community Treatment

Computers and process description for community mental health care

1997 ◽  
Vol 6 (S1) ◽  
pp. 81-90
Author(s):  
Rob Bale ◽  
Matthew Fiander ◽  
Tom Burns
Keyword(s):  
Mental Health ◽  
United States ◽  
Health Care ◽  
Case Management ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Assertive Community Treatment ◽  
The United States ◽  
Community Treatment ◽  
Practice Characteristics

The focus of mental health care has seen a significant shift from institutional care to community based care and has been well described (Thornicroft & Bebbington, 1989). This shift has necessitated the development of new and flexible models for ensuring that patients' needs are met. Mental health professionals have to operate across a wide range of community contexts dealing with a complex range of needs. Intensive Case Management (ICM) also known as Assertive Community Treatment is a model of service provision to the long term mentally ill in the community. The Programme of Assertive Community Treatment (ACT) developed by Stein & Test (1980) in the United States has a number of Key elements (figure 1).ACT-based ICM is unusual in that it has been extensively researched (principally in the United States of America), and programmes are relatively well described. Such descriptions, especially of programmes outside America, often focus on underlying principals and philosophies and do little to measure practice. Teague et al. (1995), however, devised clear criteria for measuring practice components and McGrew et al. (1994) asked ACT “experts” to rate the “key” elements of PACT and related a number of these to levels of hospital use. In the United Kingdom, Thornicroft (1991) listed twelve axes for describing the central practice characteristics of case management (a broad concept including ICM). These UK ‘practice characteristics’ also focus more on macro-level programme description rather than on the practices of programme staff. There is a pressing need for research into exactly what teams do.

A Comparison of Experts' Perspectives on Assertive Community Treatment and Intensive Case Management

2002 ◽  
Vol 53 (2) ◽  
pp. 207-210 ◽  
Author(s):  
Richard Schaedle ◽  
John H. McGrew ◽  
Gary R. Bond ◽  
Irwin Epstein
Keyword(s):  
Case Management ◽  
Assertive Community Treatment ◽  
Community Treatment ◽  
Intensive Case Management
Sign in / Sign up

Export Citation Format

Share Document