The effectiveness of psychiatric discharge coordinators

Walker, Shona A.; Naji, Simon Alexander; Howie, F. L.; Andrew, Jane; Cameron, Isobel M.; Eagles, John M.

doi:10.1185/135525700543370

Cited by 7 publications

(19 citation statements)

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“…Interestingly, many of the pilot studies found no or little effect of the interventions and it seems such interventions are rarely re-tested. For example, to our knowledge Walker et al, [59] is the only study to specifically test 'discharge coordinators' 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 [70]. Some studies use a similar approach, such as care managers responsible for facilitating discharge [65], but the name 'discharge co-ordinator' has not been tested to our knowledge since it was reported ineffective in 2000.…”

Section: Assessing Robustnessmentioning

confidence: 95%

“…Seven role-based intervention studies were included. One study introduced a discharge co-ordinator to improve communication between primary and secondary care but found no significant difference in outcomes (readmission, length of stay, satisfaction, mental health) in a large scale controlled study [37]. Similarly, one large scale RCT found no effect of a Post-Discharge Network Coordinator on readmission, social support, quality of life or mental health [38].…”

Section: Role-based Interventionsmentioning

confidence: 99%

“…The most common challenge that the interventions aimed to solve was readmission to an acute ward within a given short-term period, sometimes indicative of shortcomings in service provision [6,18,53,54,[58][59][60][61][62]25,26,28,33,36,38,40,41]. Whilst some studies found evidence for a reduction in readmission due to the interventions [26,28,40], many failed to evidence this effect [6,33,36].…”

Section: Reducing Readmissionmentioning

confidence: 99%

“…Many of the interventions that failed to reduce readmission, were arbitrarily categorised as rolebased, e.g. psychiatric discharge co-ordinators [59], pharmacy discharge planners [60], community link team [41], post-discharge network co-ordinators [38]. This suggests that it may not be sufficient to introduce a new role as a single intervention.…”

Section: Reducing Readmissionmentioning

confidence: 99%

“…Whereas interventions that focus on a single element of the care pathway, or a single person seem less successful in solving this problem, for example the introduction of a team to co-ordinate discharge planning had little effect on length of stay [63,68]. Similarly, introducing a single professional to address this challenge [59] or relying on the education of the service user [47], also proved unsuccessful. This could indicate that individual agents i.e.…”

Section: Accelerating Dischargementioning

confidence: 99%

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Interventions to Improve Discharge from Acute Adult Mental Health Inpatient Care to the Community: Systematic Review and Narrative Synthesis

Wright

Waring

2019

Preprint

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Background: The transition from acute mental health inpatient care to community care is often a vulnerable period in the pathway, where people can experience additional risks and anxiety. Researchers globally have developed and tested a number of interventions that aim to improve continuity of care and safety in the transitions. However, there has been little attempt to compare and contrast the interventions and specify the variety of safety threats they attempt to resolve. Methods: 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 service to community care services at the point of discharge. 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. Peer reviewed papers were eligible for inclusion if they addressed adults admitted to an acute inpatient mental health ward and reported on health interventions surrounding discharge from the acute ward to the community. The results were analysed using a narrative synthesis technique. Results: The total number of papers from which data was extracted was 45. The review found various interventions implemented across continents, addressing problems related to different aspects of discharge. Some interventions followed a distinct named approach (i.e. Critical Time Intervention, Transitional Discharge Model) others were grouped based on key components (i.e. peer support, pharmacist involvement). The primary problems interventions looked to address were reducing readmission, improving wellbeing, reducing homelessness, improving treatment adherence, accelerating discharge, reducing suicide. The 69 outcomes reported across studies were heterogeneous, meaning it was difficult to conduct comparative quantitative meta-analysis or synthesis. Conclusions: The interventions reviewed are spread across a spectrum ranging from addressing a single problem within a single agency with a single solution, to multiple solutions addressing multi-agency problems. We recommend that future research attempts to improve homogeneity in outcome reporting.

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Section: Assessing Robustnessmentioning

confidence: 95%

Section: Role-based Interventionsmentioning

confidence: 99%

Section: Reducing Readmissionmentioning

confidence: 99%

Section: Reducing Readmissionmentioning

confidence: 99%

Section: Accelerating Dischargementioning

confidence: 99%

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Interventions to Improve Discharge from Acute Adult Mental Health Inpatient Care to the Community: Systematic Review and Narrative Synthesis

Wright

Waring

2019

Preprint

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Developing a core outcome set for interventions to improve discharge from mental health inpatient services: a survey, Delphi and consensus meeting with key stakeholder groups

2020

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ObjectiveTo develop a core set of outcomes to be used in all future studies into discharge from acute mental health services to increase homogeneity of outcome reporting.DesignWe used a cross-sectional online survey with qualitative responses to derive a comprehensive list of outcomes, followed by two online Delphi rounds and a face-to-face consensus meeting.SettingThe setting the core outcome set applies to is acute adult mental health.ParticipantsParticipants were recruited from five stakeholder groups: service users, families and carers, researchers, healthcare professionals and policymakers.InterventionsThe core outcome set is intended for all interventions that aim to improve discharge from acute mental health services to the community.ResultsNinety-three participants in total completed the questionnaire, 69 in Delphi round 1 and 68 in round 2, with relatively even representation of groups. Eleven participants attended the consensus meeting. Service users, healthcare professionals, researchers, carers/families and end-users of research agreed on a four-item core outcome set: readmission, suicide completed, service user-reported psychological distress and quality of life.ConclusionImplementation of the core outcome set in future trials research will provide a framework to achieve standardisation, facilitate selection of outcome measures, allow between-study comparisons and ultimately enhance the relevance of trial or research findings to healthcare professionals, researchers, policymakers and service users.

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Interventions to improve discharge from acute adult mental health inpatient care to the community: systematic review and narrative synthesis

Tyler

Wright

Waring

2019

BMC Health Serv Res

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BackgroundThe transition from acute mental health inpatient to community care is often a vulnerable period in the pathway, where people can experience additional risks and anxiety. Researchers globally have developed and tested a number of interventions that aim to improve continuity of care and safety in these transitions. However, there has been little attempt to compare and contrast the interventions and specify the variety of safety threats they attempt to resolve.MethodsThe 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. 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. 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. The results were analysed using a narrative synthesis technique.ResultsThe total number of papers from which data were extracted was 45. The review found various interventions implemented across continents, addressing problems related to different aspects of discharge. Some interventions followed a distinct named approach (i.e. Critical Time Intervention, Transitional Discharge Model), others were grouped based on key components (i.e. peer support, pharmacist involvement). The primary problems interventions looked to address were reducing readmission, improving wellbeing, reducing homelessness, improving treatment adherence, accelerating discharge, reducing suicide. The 69 outcomes reported across studies were heterogeneous, meaning it was difficult to conduct comparative quantitative meta-analysis or synthesis.ConclusionsThe interventions reviewed are spread across a spectrum ranging from addressing a single problem within a single agency with a single solution, to multiple solutions addressing multi-agency problems. We recommend that future research attempts to improve homogeneity in outcome reporting.

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The effectiveness of psychiatric discharge coordinators

Cited by 7 publications

References 0 publications

Interventions to Improve Discharge from Acute Adult Mental Health Inpatient Care to the Community: Systematic Review and Narrative Synthesis

Interventions to Improve Discharge from Acute Adult Mental Health Inpatient Care to the Community: Systematic Review and Narrative Synthesis

Developing a core outcome set for interventions to improve discharge from mental health inpatient services: a survey, Delphi and consensus meeting with key stakeholder groups

Interventions to improve discharge from acute adult mental health inpatient care to the community: systematic review and narrative synthesis

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