Objective The primary purpose of this study was to evaluate whether psychotherapy format (videoconferencing, telephone or in‐person) influenced therapist empathic accuracy and clients’ perceptions of the therapeutic alliance. We also evaluated whether client attitudes towards using telepsychology influenced the therapeutic alliance in the telepsychology formats. A secondary purpose was to determine whether empathic accuracy predicted the therapeutic alliance differently across service delivery formats. Method A randomised block design was used to assign volunteer clients (N = 58) to receive one session of psychotherapy in a videoconferencing, telephonic or in‐person format. Clients completed two therapeutic alliance measures and a telepsychology attitudes measure, and both therapists and clients completed an empathic accuracy measure. Results There were no statistically significant differences between the conditions on therapist empathic accuracy or therapeutic alliance. Attitudes towards telepsychology and empathic accuracy were both significant predictors of alliance in the telepsychology delivery formats. Interestingly, empathic accuracy did not predict the therapeutic alliance for clients in the in‐person condition. Conclusions Although preliminary, the results suggest that the technology‐mediated psychotherapy processes of empathic accuracy and therapeutic alliance seem to be similar to in‐person psychotherapy. Empathic accuracy, however, may be a more salient process for clients who receive services in a telepsychology format. Process‐focused research may highlight important distinctions in technology‐mediated psychological services that inform both practice and policy.

High psychiatric readmission rates continue while evidence suggests that care is not perceived by patients as "patient centered." Research has focused on aftercare strategies with little attention to the inpatient treatment itself as an intervention to reduce readmission rates. Quality improvement strategies based on patient-centered care may offer an alternative. We evaluated outcomes and readmission rates using a benchmarking methodology with a naturalistic data set from an inpatient psychiatric facility (N = 2,247) that used a quality-improvement strategy called systematic patient feedback. Benchmarks were constructed using randomized clinical trials (RCTs) from inpatient treatment for depression, RCTs from patient feedback in outpatient settings, and national data on psychiatric hospital readmission rates. A systematic patient feedback system, the Partners for Change Outcome Management System (PCOMS), was used. Overall pre-post effect sizes were d = 1.33 and d = 1.38 for patients diagnosed with a mood disorder. These effect sizes were statistically equivalent to RCT benchmarks for feedback and depression. Readmission rates were 6.1% (30 days), 9.5% (60 days), and 16.4% (180 days), all lower than national benchmarks. We also found that patients who achieved clinically significant treatment outcomes were less likely to be readmitted. We tentatively suggest that a focus on real-time patient outcomes as well as care that is "patient centered" may provide a path toward lower readmission rates in addition to other evidence-based strategies after discharge. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Clinical and managerial competence, engagement with their employees, and presence on the unit are keys to retaining a satisfied nursing workforce.

Regular, interdisciplinary group meetings, "huddles," may be useful in improving communication among disciplines, resolving problems, and sharing information. Daily use of huddles may contribute to the development of a highly reliable health care organization. The purpose of this study was to describe safety huddles in relation to (1) problem type, (2) timeliness of resolution, (3) attendance of representatives from each discipline, (4) amount of information sharing, and (5) attendees' satisfaction with the process. Overall, results demonstrated that the primary function of huddles was the exchange of information that posed or had the potential to pose safety risks to patients. Across seven hospitals, the range of information sharing during huddles was 61.0% to 95.6%. Regarding satisfaction with the huddle process, staff reported that huddles were useful in improving awareness of safety concerns and also improved communication between disciplines. Huddles provide a structured format in which staff can positively impact safety concerns, form a greater sense of medical community, increase sharing of information between disciplines, quickly resolve discipline-based problems, and increase awareness of safety concerns. Given the results of this study, it is recommended that health care administrators and managers develop a huddle process.