The Transitional Discharge Model: Comparing Implementation in Canada and Scotland

Forchuk, Cheryl; Reynolds, William J.; Sharkey, Siobhan; Martin, Mary Lou; Jensen, Elsabeth

doi:10.3928/02793695-20071101-07

Cited by 13 publications

(11 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The intervention that was developed as a result of the modified Nominal Group Technique is similar and potentially complementary to some of the interventions currently proposed in the literature. For example, past research has highlighted the importance of ward staff developing therapeutic relationships with patients that continue after discharge until a therapeutic relationship is established with community mental health professionals (20,34,35). Effective model that focuses on relationships between healthcare professionals and patients could be further reinforced by simultaneously strengthening multiagency professional relationships and communication between agencies through the introduction of a multiagency discharge team, strengthened information systems, and inclusive, technology enabled meetings.…”

Section: Discussionmentioning

confidence: 99%

Codesigning a Mental Health Discharge and Transitions of Care Intervention: A Modified Nominal Group Technique

et al. 2020

View full text Add to dashboard Cite

Background: Discharge from acute mental health services has long been associated with mortality, risk, and related adverse outcomes for patients. Many of the interventions that currently aim to reduce adverse outcomes focus on a single group of healthcare professionals within a single healthcare setting. A recent systematic review highlights very few robust interventions that specifically aim to improve communication across services. However the importance of promoting interagency working and improving information flow between services is continually highlighted as a key priority.Methods: Using a novel codesign and experience based approach we worked with a multistakeholder group to develop possible solutions to reduce the adverse outcomes commonly associated with discharge from acute mental health services. This utilized a modified Nominal Group Technique and creative problem solving method to follow a fourstage process: Problem Identification, Solution Generation, Decision-Making, Prioritization and Implementation. Thirty-two healthcare professionals and an expert by lived experienced engaged with the process that took place over two stakeholder events.Results: Stakeholders at the first event identified and agreed upon 24 potential ideas to improve discharge from acute mental health services. These were refined at the second event to four elements of an interagency intervention: a multiagency 'Discharge Team' (with designated discharge coordinator), inclusive technology enabled team meetings, universal documentation and a patient generated discharge plan.Conclusion: This is the first study to codesign an interagency mental health discharge intervention based around a discharge team. We developed a model for working that places a greater focus on a patient generated discharge plan, interagency working, and Frontiers in Psychiatry | www.frontiersin.org

show abstract

Section: Discussionmentioning

confidence: 99%

Codesigning a Mental Health Discharge and Transitions of Care Intervention: A Modified Nominal Group Technique

et al. 2020

View full text Add to dashboard Cite

show abstract

“…This helps to establish and maintain therapeutic relationships between clients and the healthcare team as clients’ transition through inpatient care to the community. Therefore, the maintenance of therapeutic relationships and community support may improve the clients’ quality of life resulting from an enhanced sense of hope through the community integration process and leading to reduced readmissions (Burke et al ; Forchuk et al ).…”

Section: Discussionmentioning

confidence: 99%

“…A recent study showed that providing psychiatric clients with peer support in the post‐discharge period was an essential constituent facilitating the clients’ experience of discharge, thereby positively improving health outcomes in the areas of client recovery, well‐being, and reduction of readmission to the hospital (Scanlan et al ). Likewise, the provision of peer support has been shown to improve several aspects of quality of life, such as satisfaction with living situation, personal safety, and financial management (Felton et al ; Forchuk et al ; Forchuk et al ). Furthermore, Forchuk et al () found that clients who were involved with a TDM intervention reported improved quality of life concerning social relations compared to the control group.…”

Section: Introductionmentioning

confidence: 99%

Healthcare professionals’ perceptions of the implementation of the transitional discharge model for community integration of psychiatric clients

Forchuk

Martin

Sherman³

et al. 2019

Int J Mental Health Nurs

View full text Add to dashboard Cite

Research has demonstrated the benefits of mental healthcare interventions that ensure a safe transition of clients throughout the discharge and community integration process. This paper reports on qualitative data from focus groups with health professionals collected as part of a larger a mixed method study designed to examine the effectiveness and sustainability of implementing the transitional discharge model. Data collection involved two sets of focus groups, which were held at six months and one-year post-implementation. There were 216 health professional participants from nine (9) hospitals across the Province of Ontario, Canada. Data analysis used a four-step ethnographic framework by Leininger (1985) to identify descriptors and recurrent and major themes. The study identified four major themes, including healthcare professionals' roles and positive experiences in implementing the transitional discharge model; perceived benefits of the model; challenges to implementing the model; and suggestions for sustaining the model's implementation. Healthcare professionals felt that the implementation of the transitional discharge model has the potential for increasing their awareness of the process of clients' integration, serving as a framework for discharge planning, and reducing hospital readmissions. The study findings may provide healthcare providers with information on pragmatic ways to plan clients' discharge, to bridge the gap between hospital and community care, and to positively impact client health outcomes.

show abstract

“…2007). Different groups also vary with regards to the factors that facilitate versus challenge TRM implementation (Forchuk et al . 2007b).…”

Section: Introductionmentioning

confidence: 99%

Integrating an evidence‐based intervention into clinical practice: ‘transitional relationship model’

Forchuk¹,

Martin²,

Jensen³

et al. 2012

Psychiatric Ment Health Nurs

View full text Add to dashboard Cite

Accessible summary The transitional relationship model (TRM) facilitates the discharge of psychiatric clients from hospital to community by providing hospital staff involvement until a therapeutic relationship has been established with a community care provider as well as peer support. Psychiatric wards at six hospital sites implemented the TRM in three waves. Monthly summaries, progress reports, meeting minutes and focus group discussions were reviewed in order to uncover facilitators and barriers to TRM implementation. Factors that facilitated TRM implementation included: educational modules for staff and peer training, the presence of on‐site champions, and supportive documentation systems. Barriers included: feeling swamped/overwhelmed, death by process, team dynamics and changes in champions. Implementation strategies suggested by the initial hospital wards were used to enhance implementation on subsequent wards, leading to positive outcomes. This study highlights the need to address work environment issues when implementing healthcare interventions, particularly for interprofessional teams. Abstract The transitional relationship model (TRM) facilitates the discharge process by providing peer support and hospital staff involvement until a therapeutic relationship has been established with a community care provider. A quasi‐experimental, action‐oriented research design was employed in which psychiatric wards at six hospital sites implemented the model in three waves. Helpful strategies were identified by each wave of wards for consideration by subsequent wards. Using an ethnographic approach, qualitative data were examined to uncover experiences and perceptions of TRM implementation and to help identify key issues that were supporting or hampering implementation. Specific strategies that facilitate the implementation of TRM include: (1) the use of educational modules for on‐ward hospital staff training and peer training; (2) presence of on‐site champions; and (3) supportive documentation systems. Issues identified as barriers to implementation included: (1) feeling drowned, swamped and overwhelmed; (2) death by process; (3) team dynamics; and (4) changes in champions. Staged large‐scale implementation of the TRM allowed for iterative improvements to the model leading to positive outcomes. This study highlights the need to address work environment issues, particularly interprofessional teams.

show abstract

The Transitional Discharge Model: Comparing Implementation in Canada and Scotland

Cited by 13 publications

References 9 publications

Codesigning a Mental Health Discharge and Transitions of Care Intervention: A Modified Nominal Group Technique

Codesigning a Mental Health Discharge and Transitions of Care Intervention: A Modified Nominal Group Technique

Healthcare professionals’ perceptions of the implementation of the transitional discharge model for community integration of psychiatric clients

Integrating an evidence‐based intervention into clinical practice: ‘transitional relationship model’

Contact Info

Product

Resources

About