Some characteristics of effective psychiatric treatment programs.

Ellsworth, Robert B.; Collins, Joseph F.; Casey, Nancy A.; Schoonover, Reginald A.; Hickey, Robert H.; Hyer, Leon A.; Twemlow, Stuart W.; Nesselroad, John R.

doi:10.1037/0022-006x.47.5.799

Cited by 44 publications

(14 citation statements)

References 11 publications

(19 reference statements)

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“…From previous studies there is an agreement that a mixture of diagnostic groups is bene cial to psychotic patients (4,5,11,25,26). This was not the case in the present study, though almost all patients treated at the PRU had a psychosis diagnosis.…”

Section: Discussionsupporting

confidence: 55%

Stability of perceived ward atmosphere over time, diagnosis and gender for patients with psychosis

Jansson

Eklund

2002

Nordic Journal of Psychiatry

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In this study the focus was on patients with psychosis treated in a psychiatric rehabilitation unit in southern Sweden. The study described the stability of the ward atmosphere over 2 years, as well as differences between subgroups of patients regarding gender and diagnosis. Furthermore, the perceived ward atmosphere was compared with what has been recommended in the literature. The ward atmosphere was measured by The Community-Oriented Programs Environment Scale (COPES) five times during a 2-year period. The ward atmosphere was fairly stable over time, and in several respects it met the recommendations suggested for psychotic patients. There were few differences between schizophrenia patients and patients with other psychoses. No difference was found in perceived ward atmosphere with respect to gender. The study showed that the investigated unit, admitting almost only patients with psychosis, could provide a ward atmosphere accordance with the recommendations, probably due to a carefully planned program with a psychodynamically oriented supportive treatment milieu.

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Section: Discussionsupporting

confidence: 55%

Stability of perceived ward atmosphere over time, diagnosis and gender for patients with psychosis

Jansson

Eklund

2002

Nordic Journal of Psychiatry

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“…Literature on staffing levels and outcomes in psychiatric wards is limited and has shown that the presence of regular staff on wards had an association with lower rates of incidents of physical aggression, self-harm and violent incidents (Bowers, Allan, Simpson, Nijman, & Warren, 2005;Chou, Lu, & Mao, 2002;Lanza, Kayne, Hicks, & Milner, 1994). Literature also reports that more staff can lead to more violence (Owen, Tarantello, Jones, & Tennant, 1998), and some studies report no connection between staff/patient ratios and outcomes (Ellsworth et al, 1979). More recent data from the City-128 study, which collected end-of-shift reports on patient outcomes (conflicts and containment) for 6 months from a random sample of 136 English acute psychiatric wards, showed that regular qualified nurse staffing levels in the preceding shifts were associated with raised conflict and containment levels.…”

Section: Introductionmentioning

confidence: 99%

Cost‐effectiveness of staffing levels on conflict and containment on psychiatric wards in England

Kartha

McCrone

2019

Psychiatric Ment Health Nurs

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Accessible Summary What is known on the subject? Literature on staffing levels and outcomes in psychiatric wards is limited and shows mixed associations Lack of economic evidence on conflicts and containment in psychiatric care Data from the City‐128 study showed that regular qualified nurse staffing levels in the preceding shifts were associated with raised conflict and containment levels What this paper adds to existing knowledge? This is the first economic analysis using the City‐128 data, with costs and outcomes data have been combined. Cost‐effectiveness of different staffing levels in relation to conflicts and containments in England, using data from the City‐128 study Both day and night shifts appeared to show that the low staff scenario was cost‐effective in terms of conflicts and containment averted, even after attempts were made to adjust for patient severity What are the implications for practice? This paper could be an indication towards further investigation into how mental health inpatient care, specially nursing is organized in England. AbstractIntroductionEvidence from City‐128 study shows a positive association between staffing levels and conflicts/containment. Economic evidence on this topic is scarce, with no economic analyses combining costs and outcomes.Aim/QuestionTo assess the cost‐effectiveness of different staffing levels in relation to conflicts and containments in England, using City‐128 study data.MethodsShifts were grouped into three groups based on staff‐to‐bed ratio. Cost information was combined with total conflicts and containment measures to assess cost‐effectiveness.ResultsThe cost‐effectiveness analysis of the three staffing scenarios for both day and night shifts appeared to show that the low staff scenario was cost‐effective in terms of conflicts and containment averted, even adjusting for patient severity. A production function analysis also revealed that increased staff numbers were associated with higher numbers of events.DiscussionCausation cannot be attributed and neither can recommendations be made on optimal staffing levels. The impact on other outcomes such as symptoms, functioning and length of stay, and other factors should be explored, and these may all benefit from increased staff numbers.Implications for practiceThese results indicate that increasing staff numbers may not necessarily improve conflict and containment outcomes. They may produce positive outcomes in other domains.

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“…The program characteristics studied were divided into setting characteristics, which are typically not under staff control, and treatment characteristics, which usually are under staff control. Previous articles (Collins, Ellsworth, Casey, Hickey, & Hyer, 1984;Ellsworth et al, 1979) described the study design and methodology in detail and presented findings that pertained to the best subsets of setting and treatment characteristics based on multiple regression techniques. It was found that psychiatric patients had better outcomes in settings in which there was a greater mixture of acute and chronic patients and in which patients had less opportunity to withdraw from social interactions.…”

mentioning

confidence: 99%

Treatment characteristics of psychiatric programs that correlate with patient community adjustment

Collins¹,

Casey²,

Hickey³

et al. 1985

J. Clin. Psychol.

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This large Veterans Administration cooperative study sought to identify the ward milieu characteristics of effective psychiatric programs. It was developed as a multivariable, correlational study that involved systematic observations of program characteristics and outcome effectiveness of wards as they operated in their usual manner. Seventy‐nine wards in 18 hospitals provided 11,283 patients eligible for follow‐up. Eleven treatment characteristics were found to be correlated to patients' community adjustment 3 months after discharge. These characteristics were classified into five general categories: Patient‐staff interaction, patient activities, medication practices, ward physical environment, and nursing staff rotation. The major conclusions are: (1) wards do differ in their effectiveness as measured by ratings of patient posthospital adjustment; and (2) treatment characteristics make a difference in program effectiveness as measured by patients' posthospital adjustment.

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Some characteristics of effective psychiatric treatment programs.

Cited by 44 publications

References 11 publications

Stability of perceived ward atmosphere over time, diagnosis and gender for patients with psychosis

Stability of perceived ward atmosphere over time, diagnosis and gender for patients with psychosis

Cost‐effectiveness of staffing levels on conflict and containment on psychiatric wards in England

Treatment characteristics of psychiatric programs that correlate with patient community adjustment

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