Discharging psychiatric patients from hospital

Walker, Shona A.; Eagles, John M.

doi:10.1192/pb.26.7.241

Cited by 5 publications

(4 citation statements)

References 23 publications

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“…Psychiatric discharge coordinators (single discipline/ organization) have been trialled with limited success; for example one study found little improvement in outcomes with the introduction of a psychiatric discharge coordinator (39). As our intervention proposed a group-based approach rather than a model reliant on a single individual, there is potential that group-based discharge activities may provide a basis for more direct knowledge translation that may elicit interprofessional 'bonding' at a cultural and organizational level, as suggested in previous research, ultimately providing a more successful discharge intervention.…”

Section: Discussionmentioning

confidence: 99%

Codesigning a Mental Health Discharge and Transitions of Care Intervention: A Modified Nominal Group Technique

et al. 2020

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Background: Discharge from acute mental health services has long been associated with mortality, risk, and related adverse outcomes for patients. Many of the interventions that currently aim to reduce adverse outcomes focus on a single group of healthcare professionals within a single healthcare setting. A recent systematic review highlights very few robust interventions that specifically aim to improve communication across services. However the importance of promoting interagency working and improving information flow between services is continually highlighted as a key priority.Methods: Using a novel codesign and experience based approach we worked with a multistakeholder group to develop possible solutions to reduce the adverse outcomes commonly associated with discharge from acute mental health services. This utilized a modified Nominal Group Technique and creative problem solving method to follow a fourstage process: Problem Identification, Solution Generation, Decision-Making, Prioritization and Implementation. Thirty-two healthcare professionals and an expert by lived experienced engaged with the process that took place over two stakeholder events.Results: Stakeholders at the first event identified and agreed upon 24 potential ideas to improve discharge from acute mental health services. These were refined at the second event to four elements of an interagency intervention: a multiagency 'Discharge Team' (with designated discharge coordinator), inclusive technology enabled team meetings, universal documentation and a patient generated discharge plan.Conclusion: This is the first study to codesign an interagency mental health discharge intervention based around a discharge team. We developed a model for working that places a greater focus on a patient generated discharge plan, interagency working, and Frontiers in Psychiatry | www.frontiersin.org

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Section: Discussionmentioning

confidence: 99%

Codesigning a Mental Health Discharge and Transitions of Care Intervention: A Modified Nominal Group Technique

et al. 2020

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“…The peak period of risk for readmission is in the first month (Naji et al, 1999) and the highest risk for suicide is within the first 2 weeks, with discontinuity of contact with providers highlighted as a key risk factor (King et al, 2001; Meehan et al, 2006). One half of individuals with schizophrenia miss their first-scheduled outpatient appointment following discharge (Steffen, Kosters, Becker, & Puschner, 2009), and communication between inpatient and outpatient providers is often poor (Walker & Eagles, 2002). More broadly, individuals with severe mental illness often struggle to establish community supports following lengthy hospitalizations (Clarke & Winsor, 2010), and can experience disjointed service models with inpatient care typically involving high degrees of structure and supervision which differs sharply from outpatient models (Kidd, McKenzie, & Virdee, 2014).…”

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confidence: 99%

The welcome basket revisited: Testing the feasibility of a brief peer support intervention to facilitate transition from hospital to community.

Kidd

Virdee

Mihalakakos

et al. 2016

Psychiatric Rehabilitation Journal

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“…The National Confidential Inquiry into suicide and homicide by the Scottish Executive in 2001 displayed a peak in post-discharge suicides within the first two weeks following discharge. The inquiry found that poor communication, in particular, between primary and secondary care can be involved in the cause (Walker and Eagles, 2002). Another study had previously shown that suicide rates among those discharged from inpatient psychiatric care are high within the first 28 days (Goldacre et al, 1993).…”

Section: Introductionmentioning

confidence: 99%

“…Another negative outcome is that of readmission. Work has shown that readmission rates within the first six months are between 20 and 40 per cent, and adequacy of discharge influenced rates of early rehospitalisation (Caton et al, 1984;Walker and Eagles, 2002).…”

Section: Introductionmentioning

confidence: 99%

Ensuring quality immediate discharge letters from mental health

Watson-Fargie

Cheape

2018

IJHCQA

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Purpose Immediate discharge letters (IDLs) from the mental health unit at Forth Valley Royal Hospital are vital in ensuring safe patient transfer to primary care. The purpose of this paper is to develop a standardised list of information that should be included in all IDLs, and to assess its use in practice. Design/methodology/approach Three audit cycles analysed IDLs over two-week periods for their inclusion of the standardised list. The data were assessed qualitatively. Findings Baseline measurement showed 48.7 per cent of discharges had a brief reason for admission, 15.4 per cent included a description of the patient's progress during inpatient admission, 35.9 per cent had medication alterations included and 23.1 per cent included follow-up arrangements. Following a series of interventions, analysis of subsequent IDLs demonstrated that 76.2 per cent of discharges had a brief reason for admission, 76.2 per cent included a description of the patient's progress during inpatient admission, 76.2 per cent had medication alterations included and 71.4 per cent included follow-up arrangements. Originality/value The standardised list developed will ensure quality communication and safe patient transfer to primary care; the application of this list was effective and cost neutral.

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Discharging psychiatric patients from hospital

Cited by 5 publications

References 23 publications

Codesigning a Mental Health Discharge and Transitions of Care Intervention: A Modified Nominal Group Technique

Codesigning a Mental Health Discharge and Transitions of Care Intervention: A Modified Nominal Group Technique

The welcome basket revisited: Testing the feasibility of a brief peer support intervention to facilitate transition from hospital to community.

Ensuring quality immediate discharge letters from mental health

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