scholarly journals Using evidence-based dissemination and implementation strategies to improve routine communication between general practitioners and community mental health teams

2004 ◽  
Vol 28 (1) ◽  
pp. 8-11 ◽  
Author(s):  
Tracy White ◽  
Sarah Marriott
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
General Practitioners ◽  
Good Practice ◽  
Implementation Strategies ◽  
Dissemination And Implementation ◽  
Care Providers ◽  
Mental Health Team ◽  
Clinical Communication

Aims and MethodTo improve the quality of written communication between general practitioners (GPs) and community mental health team (CMHT) members concerning patients newly referred to two inner-city CMHTs. Following a benchmark audit of a random sample of referral and assessment letters, locally agreed good practice protocols were shared widely, accompanied by a dissemination and implementation strategy.ResultsSignificant improvements occurred in both GP and CMHT letters; these were most dramatic after 1 year, but tailed off considerably in the second year despite continued efforts to implement the protocols' standards.Clinical ImplicationsPlanned dissemination and implementation strategies can help to improve routine clinical communication between CMHTs and GPs through the use of good practice protocols, thus improving shared working between primary and secondary care providers.

scholarly journals Quality standards for community mental health teams

2009 ◽  
Vol 33 (10) ◽  
pp. 387-389 ◽  
Author(s):  
Richard Laugharne ◽  
Rohit Shankar
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Local Community ◽  
Evidence Based ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Team Members ◽  
Health Team ◽  
Staff Performance

SummaryThere is an increasing requirement for mental health services to demonstrate the quality of care provided. We have developed a quality report of our local community mental health team in Cornwall and suggest quality measures that we believe are useful to patients and clinicians, and possible to implement without overwhelming busy team members. They include measures of satisfaction, accessibility, safe process and review, outcomes, evidence-based practice and staff performance. Different teams may need different standards but we hope this paper will stimulate discussion and debate.

scholarly journals Improving methods of assessment in a community mental health team

1996 ◽  
Vol 20 (1) ◽  
pp. 30-32 ◽  
Author(s):  
Adrian Treloar
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Clinical Information ◽  
The Elderly ◽  
Case Note ◽  
Dramatic Improvement ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team

Changing methods of recording psychiatric histories by a community mental health team for the elderly was associated with a dramatic improvement in the quality of recording of clinical Information and of communication with general practitioners. Comparison is made with published studies of case note audit with feedback. It is suggested that restructuring the way we work may be more effective than simple review of case notes with feedback.

scholarly journals Improving the process of zoning in a community mental health team

2020 ◽  
Vol 9 (1) ◽  
pp. e000659
Author(s):  
Alexander Adams ◽  
Jennifer Perry ◽  
Stephanie Young
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Improvement Project ◽  
Health Team ◽  
Barriers To Change ◽  
Management Plans ◽  
Consistent Change

IntroductionA zoning system is used to ensure that service users receive appropriate levels of support while they are using community mental health team (CMHT) services. Patients are split into red, amber and green zones and are discussed in a daily morning meeting to ensure management plans are in place. We identified that the meeting was an area for improvement as initial feedback indicated that the meeting was repetitive, newcomers to the team found that they did not understand why patients were in different zones and discussions were not being documented. Our three aims for the project were to improve staff-rated satisfaction by 25%, to improve weekly documentation of discussions to 100% and to improve the quality of information handed over by 25% over 4 months.MethodsWe used the Model for Improvement and "plan, do, study, act" (PDSA) cycles to test change ideas such as having someone chair the meeting, use of a ‘situation, background, assessment, recommendation, decision’ (SBARD) format to handover, introduction of a blue zone for inpatients and documentation in a specific part of the electronic notes at a specific time.ResultsWe did not find our PDSA cycles led to a consistent change in satisfaction, quality and efficiency. We found an improvement of SBARD use up to 100% although this was not always consistent and an improvement in documentation to 100% for 3 weeks however this was not sustained.ConclusionOn examining barriers to change, we found the key to sustaining improvement is in ensuring multidisciplinary team member involvement at all stages of the Quality Improvement project.

scholarly journals A community mental health team for the elderly: a survey of GPs' views on the service

1997 ◽  
Vol 21 (2) ◽  
pp. 88-90 ◽  
Author(s):  
Rebecca Eastley ◽  
Mike Nowers
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
General Practitioners ◽  
The Elderly ◽  
Postal Survey ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team

This paper reports the results of a postal survey conducted to ascertain the views of general practitioners on the service provided by a newly established community mental health team for the elderly. The possible implications of GP fundholding for specialist provision of mental health services are discussed.

scholarly journals Clinician perspectives on what constitutes good practice in community services for people with Complex Emotional Needs: A qualitative thematic meta-synthesis

2020 ◽  
Author(s):  
Jordan Troup ◽  
Billie Lever-Taylor ◽  
Luke Sheridan Rains ◽  
Eva Broeckelmann ◽  
Jessica Russell ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Good Practice ◽  
Community Mental Health Services ◽  
Therapeutic Relationships ◽  
Emotional Needs ◽  
Clinician Perspectives

Introduction The need to improve the quality of community mental health services for people with Complex Emotional Needs (CEN) is recognised internationally and has become a renewed policy priority in England. Such improvement requires positive engagement from clinicians across the service system, and their perspectives on achieving good practice need to be understood. Aim To synthesise qualitative evidence on clinician perspectives on what constitutes good practice, and what helps or prevents it being achieved, in community mental health services for people with CEN. Methods Six bibliographic databases were searched for studies published since 2003 and supplementary citation tracking was conducted. Studies that used any recognised qualitative method and reported clinician experiences and perspectives on community-based mental health services for adults with CEN were eligible for this review, including generic and specialist settings. Meta-synthesis was used to generate and synthesise over-arching themes across included studies. Results Twenty-nine papers were eligible for inclusion. Six over-arching themes were identified: 1. The use and misuse of diagnosis; 2. The patient journey into services: nowhere to go; 3. Therapeutic relationships: connection and distance; 4. The nature of treatment: not doing too much or too little; 5. Managing safety issues and crises: being measured and proactive; 6. Clinician and wider service needs: whose needs are they anyway? The overall quality of the evidence was moderate. Discussion Through summarising the literature on clinician perspectives on good practice for people with CEN, over-arching priorities were identified on which there appears to be substantial consensus. In their focus on needs such as for a long-term perspective on treatment journeys, high quality and consistent therapeutic relationships, and a balanced approach to safety, clinician priorities are mainly congruent with those found in studies on service user views. They also identify clinician needs that should be met for good care to be provided, including for supervision, joint working and organisational support.

scholarly journals Cultural and linguistic adaptation of the multi-dimensional OXCAP-MH for outcome measurement of mental health among people living with HIV/AIDS in Uganda: the Luganda version

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Kenneth R. Katumba ◽  
Yoko V. Laurence ◽  
Patrick Tenywa ◽  
Joshua Ssebunnya ◽  
Agata Laszewska ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Care Providers ◽  
English Version ◽  
Validation Process ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Background It is rare to find HIV/AIDS care providers in sub-Saharan Africa routinely providing mental health services, yet 8–30% of the people living with HIV have depression. In an ongoing trial to assess integration of collaborative care of depression into routine HIV services in Uganda, we will assess quality of life using the standard EQ-5D-5L, and the capability-based OxCAP-MH which has never been adapted nor used in a low-income setting. We present the results of the translation and validation process for cultural and linguistic appropriateness of the OxCAP-MH tool for people living with HIV/AIDS and depression in Uganda. Methods The translation process used the Concept Elaboration document, the source English version of OxCAP-MH, and the Back-Translation Review template as provided during the user registration process of the OxCAP-MH, and adhered to the Translation and Linguistic Validation process of the OxCAP-MH, which was developed following the international principles of good practice for translation as per the International Society for Pharmacoeconomics and Outcomes Research’s standards. Results The final official Luganda version of the OxCAP-MH was obtained following a systematic iterative process, and is equivalent to the English version in content, but key concepts were translated to ensure cultural acceptability, feasibility and comprehension by Luganda-speaking people. Conclusion The newly developed Luganda version of the OxCAP-MH can be used both as an alternative or as an addition to health-related quality of life patient-reported outcome measures in research about people living with HIV with comorbid depression, as well as more broadly for mental health research.

scholarly journals Effectiveness and cost effectiveness of interpersonal community psychiatric treatment (ICPT) for people with long-term severe non-psychotic mental disorders: a multi-Centre randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mark van Veen ◽  
Bauke Koekkoek ◽  
Steven Teerenstra ◽  
Eddy Adang ◽  
Cornelis L. Mulder
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Cost Effectiveness ◽  
Community Mental Health ◽  
Mental Health Treatment ◽  
Psychiatric Treatment ◽  
Illness Management ◽  
Illness Management And Recovery ◽  
Perceived Difficulty

Abstract Background Long-term community mental health treatment for non-psychotic disorder patients with severe mental illness (SMI) who are perceived as difficult by clinicians, is poorly developed and lacks a structured, goal-centred approach. This study compares (cost-)effectiveness of Interpersonal Community Psychiatric Treatment (ICPT) with Care As Usual (CAU) on quality of life and clinician perceived difficulty in the care for non-psychotic disorder SMI-patients. A multi-centre cluster-randomized clinical tria was conducted in which Community Mental Health Nurses (Clinicians) in three large community mental health services in the Netherlands were randomly allocated to providing either ICPT or CAU to included patients. A total of 56 clinicians were randomized, who treated a total of 93 patients (59 in ICPT-group and 34 in CAU-group). Methods Primary outcome measure is patient-perceived quality of life as measured by the Manchester Short Assessment of Quality of Life (MANSA). Secondary outcome measures include clinician-perceived difficulty, general mental health, treatment outcomes, illness management and recovery, therapeutic relationship, care needs and social network. Patients were assessed at baseline, during treatment (6 months), after treatment (12 months) and at 6 months follow-up (18 months). Linear mixed-effects models for repeated measurements were used to compare mean changes in primary and secondary outcomes between intervention and control group of patients over time on an intention to treat basis. Potential efficiency was investigated from a societal perspective. Economic evaluation was based on general principles of a cost-effectiveness analysis. Outcome measures for health economic evaluation, were costs, and Quality Adjusted Life Years (QALYs). Results Half of the intended number of patients were recruited. There was no statistically significant treatment effect found in the MANSA (0.17, 95%-CI [− 0.058,0.431], p = 0.191). Treatment effects showed significant improvement in the Different Doctor-Patient Relationship Questionnaire-scores and a significant increase in the Illness Management and Recovery–scale Client-version scores). No effects of ICPT on societal and medical costs nor QALYs were found. Conclusions This is the first RCT to investigate the (cost)-effectiveness of ICPT. Compared with CAU, ICPT did not improve quality of life, but significantly reduced clinician-perceived difficulty, and increased subjective illness management and recovery. No effects on costs or QALY’s were found. Trial registration NTR 3988, registered 13 May 2013.

scholarly journals To improve the communication between a community mental health team and its service users, their families and carers

2020 ◽  
Vol 9 (4) ◽  
pp. e000914
Author(s):  
Priyalakshmi Chowdhury ◽  
Amir Tari ◽  
Ola Hill ◽  
Amar Shah
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
User Satisfaction ◽  
Service User ◽  
Service Users ◽  
Not Given ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Specialist Registrar ◽  
Health Team

This article describes the application of quality improvement (QI) to solve a long-standing, ongoing problem where service users or their carers felt they were not given enough information regarding diagnosis and medication during clinic assessments in a community mental health setting. Service users and carers had shared feedback that some of the information documented on clinic letters was not accurate and the service users were not given the opportunity to discuss these letters with the clinician. The aim of this QI project was to improve the communication between the community mental health team (CMHT) and service users and their carers. Wardown CMHT volunteered to take on this project. The stakeholders involved were the team manager and deputy manager, the team consultant, the team specialist registrar, team administrative manager, two carers and one service user. The project had access to QI learning and support through East London NHS Foundation Trust’s QI programme. The team organised weekly meetings to brainstorm ideas, plan tests of change to review progress and to agree on the next course of action. The outcome was an increase in service user satisfaction from 59.9% to 78% over a period of 6 months, and a reduction in complaints to zero.

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