Service quality and clinical outcomes: an example from mental health rehabilitation services in England

Abstract

Quality of care is linked to better clinical outcomes in people with complex and longer-term mental health problems. Thus, investing in quality is likely to show real clinical gains.

Evaluating outcomes in an adult inpatient psychiatric rehabilitation unit

“…10,13,37 We were also working closely with the local Trust funding panel to effectively identify cases for repatriation, and were working with the acute inpatient service to improve early identification of patients requiring rehabilitation in order to reduce delayed discharges. …”

“…They represent a 'low volume, high needs, high cost' group with difficult-to-treat illness and frequent comorbidity, who often require longer admissions and ongoing specialist mental health support to successfully live in the community after discharge. 2,3,7 Patients are often referred to rehabilitation services when their complex mental health needs mean they cannot be successfully discharged from an acute ward while further progress seems unlikely, at least in the time frame that these services operate to. They are typically unable to progress in their recovery and require intensive support, often in a structured environment, to overcome their disabilities, or are transitioning from a more-to a less-supportive environment.…”

“…Rehabilitation outcome-related factors were based on national guidelines (see Table 1). 3,13 Demographic, clinical and legal characteristics Twenty three female and thirty male patients were admitted to the inpatient rehabilitation service across the two units during the audit periods ( Table 2). The majority (68%) were admitted from the acute psychiatric inpatient unit.…”

“…[1][2][3][4] Rehabilitation services typically employ multidimensional interventions, are patient-centered and recovery-focused, with the ultimate goal of achieving successful reintegration into the community in a setting and societal role chosen by the individual. 5,6 Patients in UK psychiatric rehabilitation settings include those with severe and enduring mental illnesses, both psychotic and non-psychotic disorders.…”

Assessing the performance of mental health service facilities for meeting patient priorities and health service responsiveness

“…A core feature for assessing and benchmarking the quality of mental health service facilities is their performance on showing respect for persons and patient orientation. Incentives for patient orientations within mental healthcare are usually low (Zechmeister et al 2002); however, evidence suggests that including aspects of patient orientation and showing respect for persons in systematic performance measurements can be an effective means to improve performance (Killaspy et al 2013).…”