Psychiatric Facility Readmissions of Medicare Inpatients

2021 ◽  
pp. appi.ps.2021001
Author(s):  
Jeffrey A. Buck ◽  
Lauren Lowenstein
Keyword(s):  
2020 ◽  
Author(s):  
Daniel Poremski ◽  
Sandra Henrietta Subner ◽  
Grace Lam Fong Kin ◽  
Raveen Dev Ram Dev ◽  
Mok Yee Ming ◽  
...  

The Institute of Mental Health in Singapore continues to attempt to prevent the introduction of COVID-19, despite community transmission. Essential services are maintained and quarantine measures are currently unnecessary. To help similar organizations, strategies are listed along three themes: sustaining essential services, preventing infection, and managing human and consumable resources.


1997 ◽  
Vol 23 (2-3) ◽  
pp. 339-362
Author(s):  
Sarah C. Kellogg

In December 1995, the Eighth Circuit decided Kennedy v. Schafer, holding that a teenage patient who committed suicide while under treatment at a state psychiatric facility had a constitutionally protected liberty interest in a safe and humane environment under the Due Process Clause of the Fourteenth Amendment if her status changed from voluntary to involuntary during the course of her admission. The fifteen year old patient, Kathleen Kennedy, had been identified as a suicide risk, and had been placed on “Protective Suicide Precautions,” which required a designated staff member to keep her in constant eyesight and to interact with her at fifteen to twenty minute intervals. Despite these stringent requirements for supervision and contact, Kathleen was found dead in her room more than two hours after her last contact with a staff member. Her parents brought suit under 42 U.S.C. § 1983 against state and hospital officials, alleging that chronic understaffing and falsification of the records used to determine staffing levels amounted to a pattern of deliberate indifference to patient safety which violated their daughter’s protected liberty interest in a safe and humane environment.


2021 ◽  
pp. 107755872199892
Author(s):  
Morgan C. Shields

The Centers for Medicare and Medicaid Services implemented the Inpatient Psychiatric Facility Quality Reporting Program in 2012, which publicly reports facilities’ performance on restraint and seclusion (R-S) measures. Using data from Massachusetts, we examined whether nonprofits and for-profits responded differently to the program on targeted indicators, and if the program had a differential spillover effect on nontargeted indicators of quality by ownership. Episodes of R-S (targeted), complaints (nontargeted), and discharges were obtained for 2008-2017 through public records requests to the Commonwealth of Massachusetts. Using difference-in-differences estimators, we found no differential changes in R-S between for-profits and nonprofits. However, for-profits had larger increases in overall complaints, safety-related complaints, abuse-related complaints, and R-S-related complaints compared with nonprofits. This is the first study to examine the effects of a national public reporting program among psychiatric facilities on nontargeted measures. Researchers and policymakers should further scrutinize intended and unintended consequences of performance-reporting programs.


Author(s):  
Saba Syed ◽  
Michael Couse ◽  
Rashi Ojha

Background There is still a lot unknown about the novel Coronavirus Disease 19 (COVID-19) and its effects in humans. This pandemic has posed several challenging clinical situations to healthcare providers. Objective We hope to highlight the distinctive challenges that COVID-19 presents in patients with serious mental illness and what steps primary medical teams can take to co-manage these patients with the psychiatry consultants. Methods We present a retrospective chart review of four patients who were on psychotropic polypharmacy and admitted to our hospital from the same long-term psychiatric facility with COVID-19 delirium and other associated medical complications. Results We illustrate how the primary medical teams and psychiatrists collaborated in clinical diagnosis, treatment, and management. Conclusions Patients with serious mental illness and COVID-19 infection require active collaboration between primary medical teams and psychiatrists for diagnostic clarification, reduction of psychotropic polypharmacy to avoid adverse effects and drug-drug interactions, prevention of psychiatric decompensation, and active management of agitation while balancing staff and patient safety concerns.


2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Azan A. Nyundo ◽  
David Z. Munisi ◽  
Ainory P. Gesase

Background. Neglected tropical diseases continue to be one of the leading causes of morbidity and mortality in the developing world. Psychiatric patients are among groups at risk for parasitic infection although control and monitoring programs largely overlook this population. This study aimed at determining prevalence and factors associated with intestinal parasitic infection among patients admitted to a psychiatric facility.Method. The study followed cross-sectional design; all the residing patients that met the inclusion criteria were included in the survey. Stool samples were collected and examined by direct wet preparation and formol-ether concentration. Data were analyzed with STATA version 12.1; Chi-square test was computed to determine the level of significance atpvalue < 0.05.Results.Of all 233 patients who returned the stool samples, 29 (12.45%) screened were positive for an intestinal parasite. There was no significant association between parasite carriage and age, sex, or duration of hospital stay.Conclusion. The study shows that intestinal parasitic infection is common among patients in a psychiatric facility and highlights that parasitic infections that enter through skin penetration may be a more common mode of transmission than the oral route. Furthermore, the study underscores the need for surveillance and intervention programs to control and manage these infections.


Author(s):  
Bassema Abufarsakh ◽  
Chizimuzo T.C. Okoli

Background: Although the nursing staff is fundamental in assisting individuals with mental illnesses (MI) to stop tobacco use, they often have mixed feelings about providing tobacco treatment (TT) services to people with MI in inpatient psychiatric settings. Objective: Therefore, this study aimed to understand factors associated with nursing staff’s intentions to provide TT interventions for individuals diagnosed with MI in a psychiatric facility using the constructs of the theory of planned behavior (TPB). Method: Secondary data analysis was performed using cross-sectional data collected from 98 nursing staff who worked in a state inpatient psychiatric facility. A 15-item questionnaire was used to assess nursing staff intentions to provide TT services based on TPB constructs, including attitudes (four items), subjective norms (four items), perceived behavioral controls (four items), and intentions (three items) toward providing TT. The mean scores of each subscale ranged from 1 to 7. A logistic regression analysis was used to examine the relationship between TBP constructs and nursing staff intentions to provide TT for people with MI. Results: Nursing staff had an acceptable mean score in the intentions subscale (4.34 ± 2.01). Only two constructs of TPB explained nursing staff intentions to provide TT: subjective norms (OR = 2.14, 95% CI [1.46, 3.13]) and perceived behavioral control (OR = 2.33, 95% CI [1.32, 4.12]). Conclusions: The constructs of the TPB, the subjective norms, and the perceived behavior control were able to predict nurses’ intentions to provide TT for inpatients in a psychiatric setting. Accordingly, we suggest implementing policies that make TT a normative practice while supporting the confidence and competence of nurses to deliver TT in psychiatric facilities.


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