Use of a Critical Time Intervention to Promote Continuity of Care After Psychiatric Inpatient Hospitalization

Dixon, Lisa B.; Goldberg, Richard W.; Iannone, Virginia N.; Lucksted, Alicia; Brown, Clayton H.; Kreyenbuhl, Julie; Fang, Lijuan; Potts, Wendy

doi:10.1176/ps.2009.60.4.451

Cited by 133 publications

(111 citation statements)

References 24 publications

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“…Each of the remaining three studies relied on a nurse or social worker, 29 a patient as a peer mentor, 30 or personnel with experience in conducting clinical drug trials. 26 Outcomes Collectively, a variety of primary and secondary outcomes in five categories were reported: health outcomes; quality of life; patient satisfaction or perception of care; resource use (including readmissions); and costs.…”

Section: Study Resultsmentioning

confidence: 99%

The Importance Of Transitional Care In Achieving Health Reform

et al. 2011

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Under the Affordable Care Act of 2010, a variety of transitional care programs and services have been established to improve quality and reduce costs. These programs help hospitalized patients with complex chronic conditions-often the most vulnerable-transfer in a safe and timely manner from one level of care to another or from one type of care setting to another. We conducted a systematic review of the research literature and summarized twenty-one randomized clinical trials of transitional care interventions targeting chronically ill adults. We identified nine interventions that demonstrated positive effects on measures related to hospital readmissions-a key focus of health reform. Most of the interventions led to reductions in readmissions through at least thirty days after discharge. Many of the successful interventions shared similar features, such as assigning a nurse as the clinical manager or leader of care and including in-person home visits to discharged patients. Based on these findings, we recommend several strategies to guide the implementation of transitional care under the Affordable Care Act, such as encouraging the adoption of the most effective interventions through such programs as the Community-Based Care Transitions Program and Medicare shared savings and payment bundling experiments.

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Section: Study Resultsmentioning

confidence: 99%

The Importance Of Transitional Care In Achieving Health Reform

et al. 2011

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“…Therefore, community services need to be more proactive in contacting patients who have been recently discharged or who are risk of crisis in order to prevent further crisis. CTIs to link inpatient and community have shown to have some benefit reducing readmissions and patients attending appointments, (Dixon, et al, 2009) and so similar models might be worth implementing.…”

Section: Discussionmentioning

confidence: 99%

“…Strategies that bridge the gap between discharge and community care are needed (Dixon et al, 2009). Mistiaen, Francke and Poot, (2007) classify discharge interventions into two groups.…”

Section: Interventions At Dischargementioning

confidence: 99%

“…CTIs aim to enhance continuity of care whereby an allocated worker provides support throughout the transition, devises an individualised plan (with the client) prior to discharge for transferring care to the community and identifies potential barriers (Dixon, et al, 2009;Susser et al, 1997). CTI's have resulted in a threefold reduction in homelessness (maintained at follow-up) (Susser, et al, 1997), and significantly fewer days between discharge and first contact when compared to treatment as usual 3 (Dixon, et al, 2009). However, overall satisfaction and quality of life did not improve (Dixon, et al, 2009;Reynolds, et al, 2004).…”

Section: Interventions At Dischargementioning

confidence: 99%

“…CTI's have resulted in a threefold reduction in homelessness (maintained at follow-up) (Susser, et al, 1997), and significantly fewer days between discharge and first contact when compared to treatment as usual 3 (Dixon, et al, 2009). However, overall satisfaction and quality of life did not improve (Dixon, et al, 2009;Reynolds, et al, 2004).…”

Section: Interventions At Dischargementioning

confidence: 99%

See 2 more Smart Citations

What is the Lived Experience of Being Discharged From a Psychiatric Inpatient Stay?

Redding

Maguire

Johnson

et al. 2017

Community Ment Health J

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The first part of this thesis contains a narrative review of the literature relating to how people with mental illness cope with stigma. The majority of the research has focussed on models of stigma, the impact of stigma on individuals and campaigns to combat stigma. There is limited research exploring how people cope with stigma and the effectiveness of these strategies. The review highlights the need for further research in this area to inform interventions.The second part of the thesis contains a qualitative research study, which aimed to provide an understanding of how individuals with a mental illness described their experiences of being discharged from psychiatric inpatient stays. Suicide rates post-discharge remain high despite discharge planning and discharge interventions, yet little is known about why discharge can be so difficult for individuals. Interpretative Phenomenological Analysis (IPA) was used to analyse interviews from eight individuals who had been discharged within the last three years. The analysis highlighted five superordinate themes: the hospital experience, the experience of discharge, the outside world, the journey to health and self-beliefs/identity.The results are discussed in relation to previous findings and implications for future research and clinical practice.

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Evaluating Intensity, Complexity, and Potential for Causal Inference in Social Needs Interventions

Viswanathan,

Kennedy,

Sathe

et al. 2024

JAMA Netw Open

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ImportanceInterventions that address needs such as low income, housing instability, and safety are increasingly appearing in the health care sector as part of multifaceted efforts to improve health and health equity, but evidence relevant to scaling these social needs interventions is limited.ObjectiveTo summarize the intensity and complexity of social needs interventions included in randomized clinical trials (RCTs) and assess whether these RCTs were designed to measure the causal effects of intervention components on behavioral, health, or health care utilization outcomes.Evidence ReviewThis review of a scoping review was based on a Patient-Centered Outcomes Research Institute–funded evidence map of English-language US-based RCTs of social needs interventions published between January 1, 1995, and April 6, 2023. Studies were assessed for features related to intensity (defined using modal values as providing as-needed interaction, 8 participant contacts or more, contacts occurring every 2 weeks or more often, encounters of 30 minutes or longer, contacts over 6 months or longer, or home visits), complexity (defined as addressing multiple social needs, having dedicated staff, involving multiple intervention components or practitioners, aiming to change multiple participant behaviors [knowledge, action, or practice], requiring or providing resources or active assistance with resources, and permitting tailoring), and the ability to assess causal inferences of components (assessing interventions, comparators, and context).FindingsThis review of a scoping review of social needs interventions identified 77 RCTs in 93 publications with a total of 135 690 participants. Most articles (68 RCTs [88%]) reported 1 or more features of high intensity. All studies reported 1 or more features indicative of high complexity. Because most studies compared usual care with multicomponent interventions that were moderately or highly dependent on context and individual factors, their designs permitted causal inferences about overall effectiveness but not about individual components.Conclusions and RelevanceSocial needs interventions are complex, intense, and include multiple components. Our findings suggest that RCTs of these interventions address overall intervention effectiveness but are rarely designed to distinguish the causal effects of specific components despite being resource intensive. Future studies with hybrid effectiveness-implementation and sequential designs, and more standardized reporting of intervention intensity and complexity could help stakeholders assess the return on investment of these interventions.

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Use of a Critical Time Intervention to Promote Continuity of Care After Psychiatric Inpatient Hospitalization

Cited by 133 publications

References 24 publications

The Importance Of Transitional Care In Achieving Health Reform

The Importance Of Transitional Care In Achieving Health Reform

What is the Lived Experience of Being Discharged From a Psychiatric Inpatient Stay?

Evaluating Intensity, Complexity, and Potential for Causal Inference in Social Needs Interventions

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