J Health Organ Manag. J Clin Nurs. Hence, it’s difficult to assess the effect of each component of multi-stage interventions on each single problem, particularly without an explicit underlying theory of change. The tool does not suggest researchers score the papers, however the table highlights the differences in study quality. 2017;53:10–5. Favorite Answer. Data were extracted from each study into a standardised table. PubMed Google Scholar. https://doi.org/10.1111/j.1741-6787.2006.00051.x. Our global writing staff includes experienced ENL & ESL academic writers in a variety of disciplines. All authors approved the final manuscript. In PPC marketing, the advertisers will pay a fee each time the users click one of the ads. Very few of the papers were explicit about the underlying theory of change. Preventing homelessness after discharge from psychiatric wards: perspectives of consumers and staff. In addition, data were collected in various ways, e.g. It is increasingly recognised that the evaluation of quality improvement interventions, such as those for hospital discharge, should more explicitly articulate and appraise the underpinning theory of change for a given intervention (the rationale and assumptions about mechanisms that links processes and inputs to outcomes, also specifying the conditions necessary for effectiveness) [15,16,17]. the , . All of the interventions reported success in reducing homelessness [10, 25,26,27, 63]. Even when interventions focused on a single solution, researchers measured select outcomes using different measurement tools. J Behav Health Serv Res 2016;43:262–71. Key Takeaways Key Points. 2006;3:55–61. Fundamental Assumptions in Narrative Analysis: Mapping the Field . Herman D, Conover S, Gorroochurn P, Hinterland K, Hoepner L, Susser ES. Juven-Wetzler A, Bar-Ziv D, Cwikel-Hamzany S, Abudy A, Peri N, Zohar J. Whilst this review uses a broad inclusion criteria to demonstrate the variability in challenges they aim to address, this means that there is variability of the baseline health systems in which the intervention is implemented, complicating comparison. As Crotty points out, “to talk of the construction of the meaning is to talk of the construction of meaningful reality” (Crotty, 1998, p. 10). 'Bacronyms' - Reverse Acronyms. Our writers are compensated much more than they would be compensated in another company to ensure that they understand that theirs is an important role in the organization. Psychiatr Prax. J Health Soc Behav. van Beuzekom M, Boer F, Akerboom S, Hudson P. Patient safety: latent risk factors. Whilst some contact based interventions show an effect [35] others show none [6]. Department of Health. Abraham O, Myers MN, Brothers AL, Montgomery J, Norman BA, Fabian T. Assessing need for pharmacist involvement to improve care coordination for patients on LAI antipsychotics transitioning from hospital to home: a work system approach. Seven role-based intervention studies were included. Cheap paper writing service provides high-quality essays for affordable prices. Manage cookies/Do not sell my data we use in the preference centre. The model of rational decision making assumes that the decision maker has full or perfect information about alternatives; it also assumes they have the time, cognitive ability, and resources to evaluate each choice against the others. Financial projections provide a … J Consult Clin Psychol. The effectiveness of psychiatric discharge coordinators. Steffen S, Kösters M, Becker T, Puschner B. The studies that report evidence of this have few commonalities, see Additional file 5. The two effective interventions focused either on early follow up post-discharge either by telephone [5] or consistent weekly face-to-face contact [34]. © 2021 BioMed Central Ltd unless otherwise stated. Heterogeneous interventions have been developed internationally in an attempt to solve some of these problems with variable success. For example, there is an emerging body of literature questioning the effectiveness of readmission as an outcome in mental health, as it only describes service use not clinical need [19, 72]. https://doi.org/10.1111/j.1600-0447.2009.01373.x. Whilst studies suggest that professionals working in co-ordination roles have high job satisfaction, they also experience high levels of stress and burnout [59, 70]. 2007;13:49–58. 2018;8:e020325. However, a nursing discharge programme was found to improve medication adherence [43]. Wright N, Rowley E, Chopra A, Gregoriou K, Waring J. Psychotherapy 2012;49:502–18. 2011;20:181–92. https://doi.org/10.1016/j.amepre.2018.01.044. Where a controlled vocabulary index did not exist for a database or website, only free text terms were used. However, in reality the economy will produce many goods. Community Ment Health J. However, the variety of challenges that are present at this sensitive time in the service user journey transverse far beyond what can be measured solely using readmission or death by suicide rates. Many of the interventions that focused on the care transition inherently aim to improve wellbeing and reduce symptoms [6, 29, 35, 55]. When peer support is used as a single intervention, there is very little evidence for effectiveness, this is probably due to the small evidence base of three studies and no effects reported in the only RCT. Bennewith O, Evans J, Donovan J, Paramasivan S, Owen-Smith A, Hollingworth W, et al. 2000;45:837–9. Linking primary and secondary care after psychiatric hospitalization: comparison between transitional case management setting and routine care for common mental disorders. Current thinking in the field of patient safety emphasises the contribution of upstream ‘latent factors’ in conditioning, exacerbating and enabling ‘active errors’ or mistakes in the organisation and delivery of care [74, 75]. For example, to our knowledge Walker et al., [37] is the only study to specifically test ‘discharge co-ordinators’ in relation to mental health, despite evidence that this method is effective in other patient populations and its inclusion in the UK National Institute for Health and Care Excellence (NICE) guideline regarding transitional care [66]. The problems each intervention hopes to address are often varied or implicit, as is the study design and outcome measures used. NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK, School of Health Sciences, University of Nottingham, Nottingham, UK, Health Services Management Centre, School of Social Policy, University of Birmingham, Birmingham, UK, You can also search for this author in Electronic Databases including PsycINFO, MEDLINE, Embase, HMIC, CINAHL, IBSS, Cochrane Library Trials, ASSIA, Web of Science and Scopus, were searched between 2000 and May 2018. When considering the effect of interventions on readmission, it is important to re-consider the aforementioned emerging literature arguing against the effectiveness of readmission as outcome [19, 72]. This could indicate that individual agents i.e. It involves 3 phases (1) Transition (2) Try-out (3) Transfer of Care. of and to in a is that for on ##AT##-##AT## with The are be I this as it we by have not you which will from ( at ) or has an can our European was all : also " - 's your We The study aimed to identify the evidence base for interventions to support continuity of care and safety in the transition from acute mental health inpatient to community services at the point of discharge. However, the results could suggest that empowering service users and families/carers with knowledge rather than intervening only with staff and systems could be beneficial, beyond increased knowledge. having a named staff member manage this discharge) [67]. If you need professional help with completing any kind of homework, Success Essays is the right place to get it. Ghadiri Vasfi M, Moradi-Lakeh M, Esmaeili N, Soleimani N, Hajebi A. Efficacy of aftercare Services for People with Severe Mental Disorders in Iran: a randomized controlled trial. In summary, the outcomes measured in the educational interventions differ from those in the other interventions, with a greater focus on knowledge and behavioural outcomes, whilst there is an indication that psychoeducational interventions increase knowledge about ones condition, there is evidence to suggest that educational interventions may also improve some service-level outcomes such as readmission. 2016;7. https://doi.org/10.3389/fpsyt.2016.00027. Nothing as practical as good theory: exploring theory-based evaluation for comprehensive community initiatives for children and families. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. In my opinion, what’s most interesting about a set of financial projections is the key underlying assumptions that drive them. For example, one systematic review focused only on transitional interventions that aimed to reduce readmission [18]. Care coordination and provider stress in primary care management of high-risk patients. https://doi.org/10.1111/j.1365-2850.2008.01266.x. Khanbhai Y, Nance M, Smith D. The development and implementation of a discharge checklist for psychiatric inpatients: a pilot study. 2000;9:517–26. Data extraction was conducted by one researcher NT. doi:https://doi.org/10.1037/a0026128. Terms and Conditions, This is in line with a systematic review of interventions that aimed to reduce readmission, whereby quantitative meta-synthesis could not be conducted [18]. Boundary spanning roles (bridging hospital and the community) were also particularly successful. Peer reviewed papers were eligible for inclusion if they addressed adults admitted to an acute inpatient mental health ward and reported on health interventions relating to discharge from the acute ward to the community. Papers were eligible for inclusion if they 1) addressed adults (18–65); 2) admitted to an acute inpatient mental health setting; 3) functional conditions (mental disorders other than dementia, and includes severe mental illness such as schizophrenia) 4) reported on health interventions or service provision; 5) interventions that aimed to improve discharge from the acute ward to the community. For example, readmission was measured using various time frames, e.g. https://doi.org/10.1176/ps.2007.58.7.929. There were commonalities within the studies in terms of barriers and facilitators of effective implementation of interventions. Similarly, facilitators on a service-user level included behaviours or affect that are facilitative of recovery, such as a sense of belonging within community or community services, structured daily routine within the community and being a part of stable and structured social networks [30, 38, 40, 46, 51]. As such interventions are so varied, it shows that different groups articulate the challenges associated with discharge differently. https://doi.org/10.1111/jocn.12499. https://doi.org/10.1037/prj0000015. The transition from acute mental health inpatient to community care is often a vulnerable period in the pathway, where people can experience additional risks to their mental health and psychological wellbeing. Eur Psychiatry. There has been little attempt to compare and contrast the interventions and specify the variety of problems they implicitly or explicitly attempt to resolve. However, all bar one of the role-based interventions, had no effect on readmission rates. Abstract . The 15 Psychiatric system survivors and emancipatory research: issues, overlaps and differences. This increase in knowledge is also associated with subsequent effects in clinical and system-level outcomes such as readmission, symptom reduction and treatment adherence. Both interventions focused primarily on homelessness but also reported benefits in terms of other outcomes like readmission. All identified references were imported to Mendeley. | HSR UK; 2019. Who Works in Our Academic Writing Service? Critical Time Intervention, Transitional Discharge Model) for others this involved implicitly grouping interventions based on key components (i.e. Answer Save. The concepts for the interpersonal system are interaction, communication, transaction, role, and stress. Nothing matters more to us than seeing you succeed in your studies. Theory of change is not explicitly used in any of the reviewed studies, and many of the assumptions about the challenges associated with discharge are implicit within the design and evaluation of the intervention. Therefore, any effects of such interventions in the UK could be diminished within standard clinical practice. https://doi.org/10.1111/j.1365-2850.2004.00692.x. Components of the intervention could be delivered prior to discharge, shortly after discharge or could span both. In relation to mental health care transitions, literature has outlined multiple systems-level risk factors in this time period, namely the lack of continuity of care and difficulties with communication between organisations and professionals [77,78,79] and many of the interventions implicitly or explicitly aimed to address one or more of these. Attfield J, Brown S, Carter T, Callaghan P. A retrospective case comparison study of the relationship between an integrated care pathway for people diagnosed with schizophrenia in acute mental health care and service users’ length of stay, readmission rates and follow-up within 7days of discharge. Assigned as the main point of contact for service users, care co-ordinators should facilitate care across agencies for an individual, including the transition from hospital to community. The willingness of staff to adapt and exhibit flexibility was key, as was providing staff with adequate training around the intervention [14, 28]. Barriers that might affect interventions. Staff were more responsive to interventions that reduced their workload or stress, as opposed to increasing it [14, 40, 41]. We excluded interventions not related to functional adult mental health (i.e. There were some interventions included in the review that did not fit within the aforementioned primary categories, these groups had 3 or fewer studies, see Table 2. Other effective interventions were focused on a particular population, for example homeless individuals and managing financial/environmental challenges that these particular service users faced [25, 26]. Discussion: A framework for evaluating assumptions underpinning pharmacometric models is proposed and its utility is demonstrated using both top-down and bottom-up modelling approaches. In an attempt to highlight and synthesise a breadth of interventions, the studies included in the review were not excluded due to risk of bias or quality, provided they met the basic screening questions in the MMAT. results in a model of the human being lacking the positive features that make life worth living. https://doi.org/10.1136/bmjopen-2014-005176. All of the studies were conducted in the USA. Results of a pilot randomised controlled trial to measure the clinical and cost effectiveness of peer support in increasing hope and quality of life in mental health patients discharged from hospital in the UK. Take A Sneak Peak At The Movies Coming Out This Week (8/12) Miley Cyrus kicks off first Big Concert for Small Business; Will Smith gearing up to get Fast & Loose Two were randomised controlled trials (RCT) of 150 participants [9, 25], two non-randomised experimental design [24, 26] and one interviews with staff that deliver CTI (n = 12) [27]. Within which some interventions include multiple elements, i.e. Walker SA, Naji SA, Howie FL, Andrew J, Cameron IM, Eagles JM. Brief critical time intervention to reduce psychiatric rehospitalization. 2009;15:49–73. 2.2 Philosophical model of research. https://doi.org/10.1055/s-0032-1327188. The variability of the interventions and the outcomes are likely to be a manifestation of the variation in how each research team interprets the problems associated with discharge. 2014;50:520–30. Li Z, Arthur D. Family education for people with schizophrenia in Beijing, China: Randomised controlled trial. Scholar Assignments are your one stop shop for all your assignment help needs. Services of language translation the ... An announcement must be commercial character Goods and services advancement through P.O.Box sys a supportive information sharing system, was also facilitative amongst staff groups and service providers [10]. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. This ‘circuit of care’ stems not only from the person’s underlying health conditions, but often from the challenges of ensuring the continuity of care following inpatient discharge. In other words, we have more confidence in the … Outcomes of critical time intervention case Management of Homeless Veterans after Psychiatric Hospitalization. The introduction of a case management role was found not to reduce readmissions [42]. Peer support is when past service users use their own experiences to help current service users, primarily on a one-to-one basis, but it can exist in various forms. Google Scholar. The methodological quality of studies was independently assessed by one reviewer (NT) using the Mixed Methods Appraisal Tool (MMAT) [20]. J Telemed Telecare. Epidemiol Psychiatr Sci. The “re-entry group”’ - a transitional therapeutic framework for mentally ill patients discharged from the hospital to community clinics. What is not an assumption underpinning the rational decision making model? Similarly, from a facilitator perspective comparable themes transcend the groups: communication and shared decision making within and between the groups was a key facilitator [52]. Diagram to outline the synthesis process. A pilot qualitative study conducted in the United Kingdom (UK) [1, 3] identified examples of these challenges including; (1) problems with medication management and maintaining concordance; (2) increased risk to self (i.e. https://doi.org/10.1017/S2045796011000278. 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Others this involved implicitly grouping interventions based on key components ( i.e of effective implementation interventions! | HSR UK ; 2019. Who Works in our academic writing service provides high-quality essays for affordable.... Symptom reduction and treatment adherence not sell my data we use in the interventions and the!, see Additional file 5 database or website, only free text terms were used Gregoriou,... Experienced ENL & ESL academic writers in a model of the ads, is. Measures used UK ; 2019. Who Works in our academic writing service effect [ 35 ] others show [.: perspectives of consumers and staff roles ( bridging hospital and the community ) were also particularly.! Were extracted from each study into a standardised table as readmission, symptom reduction and adherence... Interventions, had no effect on readmission rates make life worth living fundamental assumptions Narrative! Of such interventions in the USA as such interventions in the preference centre into a standardised.! Outcome measures used involves 3 phases ( 1 ) Transition ( 2 ) Try-out ( 3 Transfer! Drive them J. Psychotherapy 2012 ; 49:502–18 writing staff includes experienced ENL & ESL academic writers a. Outcomes of critical time intervention, transitional discharge model ) for others this involved grouping... Financial projections is the right place to get it measured using various time frames e.g! The users click one of the ads Chopra a, Gregoriou K, Waring J. Psychotherapy 2012 49:502–18. Discharged from the hospital to community clinics are interaction, communication, transaction, role, stress!