scholarly journals Improving access to services through a collaborative learning system at East London NHS Foundation Trust

2018 ◽  
Vol 7 (3) ◽  
pp. e000337 ◽  
Author(s):  
Amar Shah ◽  
Auzewell Chitewe ◽  
Emma Binley ◽  
Forid Alom ◽  
James Innes
Keyword(s):  
Mental Health ◽  
Quality Improvement ◽  
Collaborative Learning ◽  
Health Services ◽  
Secondary Care ◽  
Waiting Times ◽  
Learning System ◽  
Improvement Project ◽  
Face To Face ◽  
Wide Range

Early intervention following initial referral into healthcare services can have a significant impact on the prognosis and outcomes of patients. Long waiting times and non-attendance can have an immediate and enduring negative impact on patients and healthcare service providers. The traditional management options in reducing waiting times have largely revolved around setting performance targets, providing financial incentives or additional resourcing. This large-scale quality improvement project aimed to reduce waiting times from referral to first appointment and non-attendance for a wide range of services providing primary and secondary care mental health and community health services at East London NHS Foundation Trust (ELFT). Fifteen community-based teams across ELFT came together with the shared goal of improving access. These teams were diverse in both nature and geography and included adult community mental health teams, child and adolescent mental health services, secondary care psychological therapy services, memory services, a musculoskeletal physiotherapy service and a sickle cell service. A collaborative learning system was developed to support the teams to come together at regular intervals, share data, test and scale-up ideas through quality improvement and have access to coaching from skilled improvement advisors in the ELFT central quality improvement team. Over the course of the 2-year project, waiting time from referral to first face-to-face appointment reduced from an average of 60.6 days to 46.7 days (a 23% reduction), non-attendance at first face-to-face appointment reduced from an average of 31.7% to an average of 20.5% (a 36% reduction), while referral volume increased from an average of 1021 per month to an average of 1280 per month (a 25% increase).

scholarly journals Improving access and flow within Child and Adolescent Mental Health Services: a collaborative learning system approach

2020 ◽  
Vol 9 (4) ◽  
pp. e000832
Author(s):  
Jamie Stafford ◽  
Marco Aurelio ◽  
Amar Shah
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Collaborative Learning ◽  
Health Services ◽  
Control Charts ◽  
Waiting Times ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Learning System ◽  
Process Measures

Long waiting times for Child and Adolescent Mental Health Services (CAMHS) have been linked to poorer outcomes for those seeking care. CAMHS teams in England have seen recent increases in referrals, resulting in challenging waiting times nationally. Although recent health policy has brought an increase in funding and staffing, it is believed that only 25% of those needing care receive it. Between trusts, there is considerable variation in waiting times, leaving many waiting longer than others waiting for care. East London Foundation Trust has been seen to have higher waiting times for CAMHS than other organisations across the country between June 2017 and September 2018, seven CAMHS teams were supported to use quality improvement (QI) as part of a collaborative learning system with the aim of improving access and flow. Each team was encouraged to understand their system using basic demand and capacity modelling alongside process mapping. From this teams created project aims, driver diagrams and used Plan Do Study Act cycles to test changes iteratively. Measurement and data were displayed on control charts to help teams learn from changes. Teams were brought together to help learn from each other and accelerate change through a facilitated collaborative learning system. Of the seven teams that began the collaborative learning system, six completed a project. Across the collaborative learning system collectively there were improvements in average waiting times for first, second and third appointments, and an improvement in the number of appointments cancelled. For the individual teams involved, three saw an improvement in their project outcome measures, two just saw improvements in their process measures and one did not see an improvement in any measure. In addition to service improvements, teams used the process to learn more about their pathway, engage with service users and staff, build QI capability and learn together.

Engaging Mental Health Services in Spirituality Conversations: A Spirituality Poster and Café Spirituality

2013 ◽  
Vol 32 (2) ◽  
pp. 59-65 ◽  
Author(s):  
Sharon Smith ◽  
Nancy Clark ◽  
Andrea Grabovac ◽  
Eternal Inlakesh ◽  
Dipesh Tailor
Keyword(s):  
Mental Health ◽  
Quality Improvement ◽  
Mental Health Services ◽  
Health Services ◽  
Focus Groups ◽  
Advisory Committee ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Mental Health Recovery ◽  
Improvement Project

Spirituality can be an important resource for mental health recovery. Yet barriers exist in integrating spirituality into mental health services. This article describes a spirituality quality-improvement project that engaged the system using strategic spirituality dialogue. We formed an advisory committee; developed a spirituality framework/poster; facilitated dialogue among consumers, families, and mental health professionals in focus groups; and hosted a Café Spirituality. The findings highlight the need to create safe places for spirituality dialogue.

scholarly journals Using a quality improvement project to enhance the standard vaccination rate for long-term patients in mental health services in Qatar

2021 ◽  
Vol 5 (4) ◽  
pp. 138
Author(s):  
Nervana Elbakary ◽  
Sadaf Riaz ◽  
Islam Mahran ◽  
AhmedHani Assar ◽  
Oraib Abdallah ◽  
...  
Keyword(s):  
Mental Health ◽  
Quality Improvement ◽  
Mental Health Services ◽  
Health Services ◽  
Vaccination Rate ◽  
Quality Improvement Project ◽  
Improvement Project

scholarly journals Implementation of a Telemental Health Training Program Across a Mental Health Department

2020 ◽  
Author(s):  
Bradford Felker ◽  
Meghan M McGinn ◽  
Erika M Shearer ◽  
Gina T Raza ◽  
Sari D Gold ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Quality Improvement ◽  
Mental Health Services ◽  
Health Services ◽  
Training Program ◽  
Health Care Systems ◽  
Telemental Health ◽  
Improvement Project ◽  
Care Systems

Abstract Background: Telemental Health (TMH) is an effective way to increase access to mental health services. For this reason, many health care systems strive to make TMH a part of routine mental health services. TMH use has increased substantially in recent years; however, health care systems have found it challenging to implement TMH ubiquitously. Minimal literature addresses system wide TMH implementation efforts. To broadly expand TMH throughout a VA medical center’s mental health service, a quality improvement project was conducted to develop and implement a comprehensive, novel TMH training program for staff. Methods: This quality improvement project was informed by implementation science methodologies. PARiHS criteria and Evidence-Based QI Implementation/Facilitation guided the development and implementation of this TMH training program, which included: (a) two online TMH courses, (b) a one-day didactic training including hands-on practice and skills evaluation, and (c) weekly calls where staff could receive TMH consultation. A total of 100 interdisciplinary mental health providers from outpatient mental health clinics participated in this training over the course of two years. RE-AIM criteria were used to evaluate the effectiveness of this training program. Results: Overall, providers reported satisfaction with this TMH training program, and found that it increased their TMH knowledge and competence. The number of providers using TMH and patients who received it nearly doubled in the two years after the launch of the TMH training compared to the two years preceding. Conclusions: This novel TMH training program was well-received by staff and increased the number of providers and patients using TMH. Since this project was completed, the COVID-19 pandemic has significantly increased the demand for telehealth services. This training model offers specific strategies based upon implementation science that could be disseminated to and adopted by mental health programs looking to implement system wide TMH use.

scholarly journals Consultation liaison to support efficient delivery of mental health care

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S317-S317
Author(s):  
Emma Davies ◽  
Mihaela Bucur
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Secondary Care ◽  
Waiting Times ◽  
Individual Treatment ◽  
Efficient Treatment ◽  
Number Of Patients ◽  
The Impact

AimsTo study the impact of collaborative working, via consultation liaison, between Mental Health Liaison Practitioners (MHLPs) and Doctors within a secondary care mental health service. We hypothesise that this model of working may avoid unnecessary clinic appointments and waiting times, whilst providing patients with more efficient treatment.BackgroundMental health services are stretched, understaffed and under-resourced. It is estimated that 75% of people with mental health problems in England may not get access to the treatment they need. We therefore need efficient and innovative ways for people who seek help to receive support. Good practice consultation liaison involves face to face contact between clinicians; treatment can be delivered by supporting primary care whilst reducing the burden of secondary care mental health services.MethodRegular 30-minute sessions within an Assessment and Treatment Service, between MHLPs and Doctors, at both Consultant and Trainee level, were coordinated. Patients assessed by MHLPs were discussed by opening a dialogue whereby further management was discussed across a multi-professional team. A record was created of all patients discussed and the outcome.ResultNumber of MHLP/Doctor sessions: 10 across a six-month period.Number of patients discussed: 17.Medication advice provided for 16 patients. One patient required a referral for a clinic appointment.For several patients, integrated working procured alternative care pathways and resources to be considered, to incorporate into individual treatment plans.ConclusionRegular consultation liaison with MHLPs and Doctors is a model of working across the interface between primary care and specialist mental health services. It may provide patients with more efficient care, whilst avoiding unnecessary waiting times for clinic appointments. The consultation liaison working supported the development of an educative relationship between clinicians, with interprofessional learning. This is an example of an integrated and collaborative care model, whereby multi-professional working can provide efficient and effective treatment, whilst the support for the patient can remain in the primary care setting.

scholarly journals Mental health services for war-affected children

2003 ◽  
Vol 183 (6) ◽  
pp. 540-546
Author(s):  
Lynne Jones ◽  
Alban Rrustemi ◽  
Mimoza Shahini ◽  
Aferdita Uka
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Learning Disability ◽  
Stress Reactions ◽  
Educational Role ◽  
Number Of Patients ◽  
Wide Range ◽  
Adolescent Mental Health Service ◽  
Local Actors

BackgroundIn war-affected societies it is assumed that the major mental health problem facing the population will be stress reactions.AimsTo describe the creation of a child and adolescent mental health service (CAMHS) in Kosovo after the military conflict ended in 1999, and to establish the range of problems and diagnoses that presented.MethodData were collected on 559 patients over 2 years, including their referring problems and diagnoses.ResultsStress-related disorders constituted only a fifth of the case-load in year 1. A substantial number of patients were symptom-free but attended because they had been exposed to atraumatic event, and believed it might make them ill. Non-organic enuresis and learning disability were the most common diagnoses in year 2. Many patients had a complex mix of social and psychological difficulties that did not fit conventional diagnostic categories.ConclusionsMental health services that only address traumatic stress may fail to meet the needs of war-affected children. A comprehensive, culturally appropriate CAMHS is needed to address a wide range of problems including learning disability. It should be developed through local actors, and build on existing local infrastructure. Services can also have an educational role in ‘depathologising’ normative responses.

scholarly journals Clinical risk management and child mental health

2003 ◽  
Vol 9 (5) ◽  
pp. 319-326 ◽  
Author(s):  
Fiona Subotsky
Keyword(s):  
Mental Health ◽  
Risk Management ◽  
Health Services ◽  
Child Mental Health ◽  
Policy Development ◽  
Clinical Governance ◽  
Clinical Risk Management ◽  
New Paradigm ◽  
Adult Services ◽  
Wide Range

Risk management is a requirement of clinical governance and a new paradigm for child and adolescent mental health services. Issues are different from those of adult services and a wide range need to be considered, which include not only the risk of harm to self, to others and from others but also from the system (by omission or commission) and to the staff. Systematic policy development, using information from audits, complaints, incidents and inquiries, will be helpful and interagency agreements necessary to promote coordination. The complex regulatory framework is discussed.

scholarly journals Mental health services for war-affected children

2003 ◽  
Vol 183 (06) ◽  
pp. 540-546 ◽  
Author(s):  
Lynne Jones ◽  
Alban Rrustemi ◽  
Mimoza Shahini ◽  
Aferdita Uka
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Learning Disability ◽  
Stress Reactions ◽  
Educational Role ◽  
Number Of Patients ◽  
Wide Range ◽  
Adolescent Mental Health Service ◽  
Local Actors

Background In war-affected societies it is assumed that the major mental health problem facing the population will be stress reactions. Aims To describe the creation of a child and adolescent mental health service (CAMHS) in Kosovo after the military conflict ended in 1999, and to establish the range of problems and diagnoses that presented. Method Data were collected on 559 patients over 2 years, including their referring problems and diagnoses. Results Stress-related disorders constituted only a fifth of the case-load in year 1. A substantial number of patients were symptom-free but attended because they had been exposed to atraumatic event, and believed it might make them ill. Non-organic enuresis and learning disability were the most common diagnoses in year 2. Many patients had a complex mix of social and psychological difficulties that did not fit conventional diagnostic categories. Conclusions Mental health services that only address traumatic stress may fail to meet the needs of war-affected children. A comprehensive, culturally appropriate CAMHS is needed to address a wide range of problems including learning disability. It should be developed through local actors, and build on existing local infrastructure. Services can also have an educational role in ‘depathologising’ normative responses.

scholarly journals Improving medical residents’ utilisation of integrated mental health in primary care

2021 ◽  
Vol 10 (3) ◽  
pp. e001388
Author(s):  
Jenna Palladino ◽  
Deirdra Frum-Vassallo ◽  
Joanne D Taylor ◽  
Victoria L Webb
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Medical Home ◽  
Medical Resident ◽  
Improvement Project ◽  
Mental Health Integration ◽  
Integrated Mental Health ◽  
Over Time

BackgroundIntegration of mental health services allows for improved prevention and management of chronic conditions within the primary care setting. This quality improvement project aimed to increase adherence to and functioning of an integrated care model within a patient-centred medical home. Specifically, the project focused on improving collaboration between Primary Care Mental Health Integration (PC-MHI) and the medical resident Patient Aligned Care Teams (PACT) at a Veterans Affairs Medical Center in Northport,New York (VAMC Northport).MethodThe project used increased education, training and relationship building among the medical resident PACTs, and the establishment of regularly occurring integrated team meetings for medical and mental health providers. Education of residents was measured with a self-assessment pre-training and post-training, while utilisation was measured by the percentage of patients currently on a PACT’s panel with at least one PC-MHI encounter in the last 12 months (known in VAMC Northport as PACT-15 metric).ResultsTwo resident PACTs that received both training and weekly integrated meetings increased their utilisation of integrated mental health services by 3.8% and 4.5%, respectively. PACTs that participated in training only, with no regular meetings, showed an initial improvement in utilisation that declined over time.ConclusionsTraining alone appeared beneficial but insufficient for increased integration over time. The addition of a regularly occurring integrated weekly meeting may be a critical component of facilitating sustained mental health integration in a primary care medical home model.

Sign in / Sign up

Export Citation Format

Share Document