Better together: a day hospital's move towards integrated care

Background/AimsThis article will present how an interdisciplinary team working within a day hospital in an acute NHS Foundation Trust embraced the opportunities of practice development to work ‘better together’ to meet the complex needs of individuals using the service.MethodsBy working closely with key stakeholders, the team developed an integrated service intersecting both primary and secondary care boundaries.ResultsThe principles of practice development, including shared vision and focus, ensured changes made to the service were patient centred. These changes included a 360-degree assessment by professional staff with extended skills beyond their own professional role, and a virtual ward round, where individual patients are reviewed by an interdisciplinary team in the community with a focus on avoiding hospital admission, with quicker access to the day hospital. The team worked closely with their local university towards achieving practice development unit status, demonstrating a rigorous approach to the development of services provided by the day hospital.ConclusionsThe article highlights both the value of practice development and significantly the value of an interdisciplinary team working within a day hospital setting.

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Interdisciplinary Team Working in Physical and Rehabilitation Medicine – the European View

Physikalische Medizin Rehabilitationsmedizin Kurortmedizin ◽

10.1055/s-0029-1238184 ◽

2009 ◽

Vol 19 (04) ◽

Author(s):

C Gutenbrunner ◽

V Neumann

Keyword(s):

Interdisciplinary Team ◽

Rehabilitation Medicine ◽

Team Working ◽

Physical And Rehabilitation Medicine

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The Experiences and Perspectives of African-Australian Community Service Providers Who Work with At-Risk and Justice-Involved Youth

International Journal of Offender Therapy and Comparative Criminology ◽

10.1177/0306624x211022652 ◽

2021 ◽

pp. 0306624X2110226

Author(s):

Stephane Shepherd ◽

Aisling Bailey ◽

Godwin Masuka

Keyword(s):

Risk Factors ◽

At Risk ◽

Young People ◽

Service Delivery ◽

Community Service ◽

Service Providers ◽

Professional Staff ◽

Youth Justice ◽

Complex Needs ◽

Australian Community

African-Australian young people are over-represented in custody in the state of Victoria. It has been recognized in recent government and stakeholder strategic plans that African-Australian community service providers are well placed to help address the increasing complex needs of at-risk African-Australian youth. However little is known about the capacities of such providers to effectively contend with this growing social concern. In response, this study aimed to explore the perspectives and operational (service delivery and governance) experiences of African-Australian community organizations which provide services to at-risk young people in Victoria. Through a series of in-depth interviews with the leadership of eight key African-Australian service providers, we aimed to identify their perceived strengths, obstacles faced and proposed strategies to realize key objectives. Perspectives on key risk factors for young African-Australian justice system contact were also gathered. Several themes were extracted from the interviews, specifically (i) Risk factors for African-Australian youth justice-involvement (school disengagement, peer delinquency, family breakdown, intergenerational discord, perceived social rejection), (ii) The limitations of mainstream institutions to reduce African-Australian youth justice-involvement (too compliance focused, inflexible, business rather than human-centered, disconnected from communities and families), (iii) The advantages of African-Australian community service providers when working with African-Australian youth (community credibility, client trust, flexibility, culturally responsive), (iv) The challenges faced by African-Australian service providers (lack of funding/resources, professional staff shortages, infrastructural/governance limitations), and (v) “What works” in service provision for at-risk African-Australians (client involvement in program design, African staff representation, extensive structured programming matched with client aspirations, prioritizing relationship building, persistent outreach, mental health and legal literacy for clients and families). Implications for service delivery and social policy are discussed within.

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Guided Self-help Teletherapy for Behavioural Difficulties in Children with Epilepsy

Journal of Clinical Psychology in Medical Settings ◽

10.1007/s10880-021-09768-2 ◽

2021 ◽

Author(s):

Sophie Bennett ◽

Isobel Heyman ◽

Sophia Varadkar ◽

Anna Coughtrey ◽

Fahreen Walji ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Unmet Need ◽

Hospital Setting ◽

Physical And Mental Health ◽

Paediatric Hospital ◽

Complex Needs ◽

Self Help ◽

Behavioural Difficulties

AbstractBehavioural difficulties impact greatly upon quality of life for children with chronic illness and their families but are often not identified or adequately treated, possibly due to the separation of physical and mental health services. This case study describes the content and outcomes of guided self-help teletherapy for behavioural difficulties in a child with epilepsy and complex needs using an evidence-based behavioural parenting protocol delivered within a paediatric hospital setting. Behavioural difficulties and progress towards the family’s self-identified goals were monitored at each session. Validated measures of mental health and quality of life in children were completed before and after intervention and satisfaction was measured at the end of treatment. Measures demonstrated clear progress towards the family’s goals and reduction in weekly ratings of behavioural difficulties. This case demonstrates that a guided self-help teletherapy approach delivered from within the paediatric setting may be one way of meeting unmet need.

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Educational Digital Case Studies: Enhancing Palliative Care Communication and Interdisciplinary Team Interaction in the Hospital Setting (FR431-D)

Journal of Pain and Symptom Management ◽

10.1016/j.jpainsymman.2013.12.107 ◽

2014 ◽

Vol 47 (2) ◽

pp. 437-438

Author(s):

Randi Diamond ◽

Michele Greene ◽

Ronald Adelman ◽

Dory Hottensen ◽

Lucy Bruell ◽

...

Keyword(s):

Palliative Care ◽

Case Studies ◽

Hospital Setting ◽

Interdisciplinary Team ◽

Team Interaction

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A treatment protocol for suicidal patients in a day hospital setting: Preliminary results

Psychiatry Research ◽

10.1016/j.psychres.2005.07.036 ◽

2006 ◽

Vol 143 (2-3) ◽

pp. 307-310

Author(s):

Marianna Mazza ◽

Susanna Capitani ◽

Emanuele Barbarino ◽

Sergio De Risio ◽

Pietro Bria

Keyword(s):

Treatment Protocol ◽

Hospital Setting ◽

Day Hospital ◽

Preliminary Results ◽

Suicidal Patients

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Managing psychotic patients in a day hospital setting

Psychosis (madness) ◽

10.4324/9780429479199-6 ◽

2018 ◽

pp. 65-77

Author(s):

Richard Lucas

Keyword(s):

Hospital Setting ◽

Day Hospital

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Intensive Psychotherapy for Acute Psychiatric Patients in a Day Hospital Setting in Israel

The British Journal of Psychiatry ◽

10.1192/bjp.121.6.635 ◽

1972 ◽

Vol 121 (565) ◽

pp. 635-639 ◽

Cited By ~ 2

Author(s):

Y. Fried ◽

F. Brüll

Keyword(s):

Psychiatric Patients ◽

Hospital Setting ◽

Health Clinic ◽

Day Hospital ◽

Professional Literature ◽

Sick Fund ◽

Day Hospitals ◽

Type Of Institution ◽

Autonomous Service ◽

Intensive Psychotherapy

The psychiatric services in the field of community psychiatry in Israel have developed in a number of directions over the past decade. Following the establishment by the Workers' Sick Fund (Kupat Holim) of a Rehabilitation Unit for chronic psychiatric patients (Wijsenbeek and Lindner (53)) and the opening of a Day Hospital for acute cases in conjunction with a psychiatric hospital (Ramot and Jaffe (45)), a Day Hospital was established in October 1968, at the Out-Patient Mental Health Clinic (Ramat Chen), to serve acute psychiatric patients. This represented the first attempt of its kind in Israel. The professional literature on Day Hospitals, which in the main describes a ‘half-way out’ type of hospital (Farndale (16); Epps and Hanes (14); Kramer (32)), also reports the existence of a ‘half-way in’ type of institution, operating as an autonomous service catering to a particular geographical region, without being attached directly to a mental hospital. This kind of Day Hospital, specifically designed for acute cases, has not yet been tried in Israel.

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Transforming a Hospital through Growing, not Building, an Electronic Patient Record System

Methods of Information in Medicine ◽

10.1055/s-0038-1634538 ◽

1998 ◽

Vol 37 (03) ◽

pp. 285-293 ◽

Cited By ~ 18

Author(s):

C. J. Atkinson ◽

V. J. Peel

Keyword(s):

Health Care ◽

Electronic Patient Record ◽

Clinical Care ◽

Hospital Setting ◽

Professional Staff ◽

Patient Record ◽

Full Potential ◽

Electronic Patient Record System ◽

Health Care Organisation ◽

Record System

AbstractThe benefits for any health care provider of successfully introducing an Electronic Patient Record System (EPRS) into their organisation can be considerable. It has the potential to enhance both clinical care and managerial processes, as well as producing more cost-effective care and care programmes across clinical disciplines and health care sectors. However, realising an EPRS's full potential can be a long and difficult process and should not be entered into lightly. Introducing an EPR System involves major personnel, organisational and technological changes. These changes must be interwoven and symbiotic and must be managed so that they grow together in stages towards a vision created and shared by all clinical professional staff, other staff, and managers in that process. The use of traditional “building” or “journey” metaphors inadequately reflects the complexity, uncertainty and, therefore, the unpredictability of the process. We propose that a more useful metaphor may be of “growing” a progressively more united, unified information system and health care organisation. We suggest this metaphor better recognises that the evolutionary process appears to be more organic than predictable and more systemic than mechanistic. An illustration is given of how these organisational clinical and technical issues might evolve and interweave in a hospital setting through a number of stages.

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