Details

Autor(en) / Beteiligte

• Velligan, Dawn
• Fredrick, Megan

Titel

SA106. Engagement Focused Care During Transitions From Inpatient and Emergency Psychiatric Facilities

Ist Teil von

• Schizophrenia bulletin, 2017-03, Vol.43 (suppl_1), p.S151-S151

Ort / Verlag

US: Oxford University Press

Erscheinungsjahr

2017

Link zum Volltext

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Background: Research indicates that as many as 40% of those with SMI do not attend any outpatient visits in the 30 days following discharge. Problems in continuity of care are associated with poorer outcomes and higher health-care costs. Methods: We examined engagement focused care versus treatment as usual in a university-based transitional care clinic (TCC) with a 90-day program serving individuals with SMI discharged from hospitals and emergency rooms. Engagement focused care included a unique group intake process designed to get individuals into care rapidly and a shared decision-making coach who met with individuals to help them identify their goals and get the most out of visits with their prescribers. Assessments of quality of life, symptomatology, and shared decision-making preferences were conducted at baseline 3 months corresponding to the end of TCC treatment and 6 months post-TCC discharge. Communication between patients and providers was assessed at each visit. Service utilization was derived from medical records and monthly utilization phone calls. Results: There were no differences in show rate for individuals randomized to Access group versus traditional intake, χ 2 (1) = .45, P > .50, and both group and individual intakes were rated over 6 points on a 1–7 scale. Results indicated that subjective quality of life improved to a greater extent in engagement focused care versus standard treatment, F (1, 216) = 4.14, P < .04. There were no group differences on engagement in care post-TCC. Prescribers and patients saw session communication more similarly as time went on, but this did not differ by treatment group, F (6, 437) = 3.70; P < .002. In all, 91% of patients wanted at least some say in decisions about their treatment, although the amount of collaboration these individuals wanted from providers varies. Preferences for type of decision-making remained constant over time, and there was no group effect with respect to perceptions of treatment sessions. Conclusion: Engagement focused care can improve quality of life. More rapid access to care provided by a group intake process seems highly acceptable to consumers of mental health in transition. Shared decision-making within this context needs to be better understood as transitions represent critical times in which patients discontinue care.