Technology and Mental Health Care for Veterans: A Quality Improvement Project

2018 ◽  
Author(s):  
Rayna Sanghvi ◽  
Annika M. Miyamoto ◽  
Brandy Smith ◽  
Craig Rosen ◽  
Pearl A. McGee-Vincent
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Quality Improvement ◽  
Mental Health Care ◽  
Quality Improvement Project ◽  
Improvement Project

A quality improvement project to reduce restrictive interventions in a mental health service

2021 ◽  
pp. 1-12
Author(s):  
Darren Savarimuthu ◽  
Katja Jung
Keyword(s):  
Mental Health ◽  
Quality Improvement ◽  
Positive Impact ◽  
Essential Elements ◽  
Quality Improvement Project ◽  
Psychiatric Ward ◽  
Quality Improvement Initiative ◽  
Successful Implementation ◽  
Evidence Based ◽  
Improvement Project

Background/aims This article describes a quality improvement project that aimed to reduce restrictive interventions on an acute psychiatric ward. In light of a service level agreement and based on a trust-wide target, the purpose of the project was to reduce restrictive interventions by 20% within a period of 6 months. It was also anticipated that a least restrictive environment could have a positive impact on patient experience. Methods Three evidence-based interventions were introduced to the ward during the quality improvement project. These included positive behaviour support, the Safewards model and the productive ward initiative. Results There was a 63% reduction in restrictive interventions over a 6-month period through the successful implementation of a series of evidence-based interventions to manage behaviours that challenge on the mental health ward. Conclusions The project identified collaborative team working, staff training and adequate resources as essential elements in the success of the quality improvement initiative. However, co-production was found to be crucially significant in bringing sustainable changes in ward environment and in addressing restrictive practices.

scholarly journals Shifting to Remotely Delivered Mental Health Care: Quality Improvement in the COVID-19 Pandemic

2020 ◽  
Vol 1 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Patrick Daigle ◽  
Abraham Rudnick
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Quality Improvement ◽  
Mental Health Care ◽  
Health Care Quality ◽  
Care Quality ◽  
Health Clinic ◽  
Quality Improvement Initiative ◽  
Service Users ◽  
Specialized Mental Health

This paper presents an organizational (ambulatory) case study of shifting mental health care from in-person to remote service delivery due to the current (COVID-19) pandemic as a rapid quality improvement initiative. Remotely delivered mental health care, particularly using synchronous video and phone, has been shown to be cost-effective, especially for rural service users. Our provincial specialized mental health clinic rapidly shifted to such remote delivery during the current pandemic. We report on processes and outputs of this rapid quality improvement initiative, which serves a purpose beyond pandemic circumstances, such as improving access to such specialized mental health care for rural and other service users at any time. In conclusion, shifting specialized mental health care from in-person to remotely delivered services as much as possible could be beneficial beyond the current pandemic. More research is needed to optimize the implementation of such a shift.

Systems monitoring and quality improvement

2015 ◽  
Author(s):  
Jeffrey L. Metzner
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Quality Improvement ◽  
Mental Health Care ◽  
Health Care System ◽  
Class Action ◽  
Mental Health Care System ◽  
Monitoring Process ◽  
Consent Decrees ◽  
Correctional Mental Health

Class action litigation that includes a focus on constitutionally inadequate correctional mental health care systems has been a major and effective force in jail and prison reform during the past four decades. Benefits to correctional mental health systems resulting from such litigation have included increased resources needed to implement basic policies and procedures that are necessary for a constitutionally adequate system. Following the passage of the Prison Litigation Reform Act of 1995, newly initiated consent decrees related to class action litigation involving correctional mental health services significantly decreased. The reduction in litigation related to this act followed from limiting the discretion of judges in approving such decrees that were previously allowed. Private settlement agreements and/or memoranda of agreement or their equivalents (the “Agreement”) have been substituted for the consent decree process. Although the judicial enforcement specific to implementation of these Agreements is weak, the monitoring process of such Agreements is very similar to those previously used with consent decrees. This chapter will summarize the monitoring process frequently involved in an Agreement resulting from a class action lawsuit specific to a correctional mental health care system using a single prison mental health system as an illustrative example. Emphasis will be placed on the importance of developing a quality improvement process that should ultimately eliminate the need for a monitor external to the mental health care system.

Addressing distress in head and neck cancer patients: A quality improvement project.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 43-43
Author(s):  
Natalie Riblet ◽  
Karen Skalla ◽  
Alison Peterson ◽  
Auden McClure ◽  
Karen Homa ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Head And Neck Cancer ◽  
Quality Improvement ◽  
Mental Health Care ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Medical Oncology ◽  
Senior Leadership

43 Background: To better address the emotional needs of cancer patients by improving mental health care in Head and Neck Cancer (HNC) Medical oncology at Norris Cotton Cancer Center, Lebanon, NH, through implementing an evidence-based process for identifying and managing psychological distress. Methods: Using quality improvement methods, mental health care in HNC Medical Oncology was evaluated and revised November 2010 through April 2012. In January 2011, a two-component intervention was put into routine care including 1) the validated National Comprehensive Cancer Network (NCCN) distress thermometer (DT) and 2) a treatment decision algorithm. A licensed nursing assistant administered the DT and providers reviewed results as part of the clinical exam. Heightened distress was defined as a score of ≥ 4. Screening processes were improved through Plan-Do-Study-Act (PDSA) cycles. Results: Prior to January 2011, identification of distress was based on provider’s clinical assessment. Of 104 patients seen between November 2010 and January 2011, 25% (26) were diagnosed with psychological problems. Cause-effect diagraming suggested that lack of a formalized process for distress assessment contributed to missed diagnoses. Providers were unfamiliar with mental health resources. As reported in Psycho-Oncology 21(Suppl. 1): 51(2012) after implementing process changes, bi-weekly distress screening rates rose from 0% to 38% between January and July 2011. With additional PDSA cycles, these rates increased to 74% between October 2011 and April 2012. Similar to proposed benchmarks, 84% (47) of newly diagnosed patients (56) were assessed for distress. Furthermore, of 138 unique patients seen, 71% (98) were screened for distress and 47% (46) of these had heightened distress. Providers addressed the needs of all those identified. Improvement was attributed to the empowerment of staff and participation of senior leadership. Barriers included a heavy reliance on the presence of trained staff. Conclusions: Quality improvement methods can be applied to the cancer setting in order to create systems of care, which more reliably identify and address distress. Teams, however, must be invested in the work and receive support from senior leadership.

scholarly journals Outcomes of a quality improvement project integrating mental health into primary care

2007 ◽  
Vol 16 (5) ◽  
pp. 378-381 ◽  
Author(s):  
B. V Watts ◽  
B. Shiner ◽  
A. Pomerantz ◽  
P. Stender ◽  
W. B Weeks
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Quality Improvement ◽  
Quality Improvement Project ◽  
Improvement Project

scholarly journals Appropriate Use Criteria in Echocardiography: An Observational Institutional Study with the Perspective of a Quality Improvement Project

2016 ◽  
Vol 10 ◽  
pp. CMC.S36504 ◽  
Author(s):  
Vanessa Rameh ◽  
Antoine Kossaify
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Clinical Outcome ◽  
Quality Improvement Project ◽  
University Hospital ◽  
Appropriate Use Criteria ◽  
Appropriate Use ◽  
Improvement Project ◽  
Health Care Resources ◽  
Set Up

Background Appropriate use criteria (AUC) in echocardiography are essential tools for aligning the indications of echocardiography with the best clinical standards, improving clinical outcome, restraining abuse, and preserving health-care resources. Objectives The aim of this study was to ascertain the AUC for transthoracic echocardiography in a university hospital and create a quality improvement project (QIP). Methods The assessment of 501 inpatients who received transthoracic cardiac echo was conducted according to the 2011 AUC report. Indications were classified as appropriate, uncertain, or inappropriate, and patients not matching any of the abovementioned divisions were grouped in the nonfitting category. Results Of the 501 eligible patients, 374 patients (74.66%) were in the appropriate group, 85 patients (16.96%) in the inappropriate group, 20 patients (3.99%) in the uncertain group, and 22 patients (4.39%) in the nonfitting category. Discussion Interpretation and analysis of the obtained results are presented, along with the results of many comparable studies; moreover, a QIP was set up accordingly. Conclusion AUC are useful to assess local practice, preserve health-care resources, and improve clinical outcome.

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