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- Title
Development and Implementation of Discharge Planning Service in Roozbeh Psychological Hospital in 2016-2017.
- Authors
Toufghi, Hamidreza; Sharif, Vandad; Alaghband-RadA, Javad; Shadloo, Behrang
- Abstract
Background and objectives: Discharge planning is a dynamic, collaborative, and comprehensive process which is aimed at promoting the continuity of care after discharge and providing necessary services and support to clients and their caregivers. The effectiveness of discharge planning has recently been documented by several studies in factors like re-admission, treatment adherence, length of stay, treatment costs, symptoms resolution, and the patients' quality of life. In this respect, the researchers of the current paper decided to develop and implement a settingappropriate discharge planning service at Roozbeh Hospital. Materials and methods: The current research employed a mixed method by using an evidence-based service development and an evaluation model that followed six steps, including situation analysis, priority setting, option appraisal, program planning, implementation, and evaluation. The first four steps (i.e. the development phase) were performed by the assessment of the current health policies, available services and their effectiveness at the center, care gaps and possible operational choices, and the last two steps (i.e. evaluation phase) were conducted by implementing the discharge planning service at Roozbeh Hospital and measuring the outcomes through a one-way crossover study. In the latter phase, the outcomes were assessed before and after providing the service. The outcomes included the adherence to the follow-up visit within the first month following the discharge, medication adherence and readmission within a 3-month period after the discharge, using the 8-item version of the Morisky Medication Adherence Scale (MMAS-8), admission documents, the two telephone interviews (at the first and third months after the discharge), and the data registered on the Health Information System (HIS) of the hospital and comparing them in the 3-month period before and after providing the service in the same wards. Results: During the design phase, the researchers of the current paper found out that two indices, i.e. the mean length of admission (28 days) and the rate of follow-up visit adherence within the 6-month period after the discharge (44%) at Roozbeh hospital were not within the international standard ranges, so it was agreed that the discharge planning service be developed in detail. In the evaluation phase, 136 patients who received the newly developed service in a 3-month period were compared with 164 patients admitted in the same wards in the 3-month period before the service was developed; the results showed that adherence to the first follow-up visit and medication adherence had improved significantly in the intervention group, but no significant change had happened to their readmission. Discussion and conclusion: The development and implementation of the psychiatric discharge planning service have taken place for the first time in Iran at Roozbeh Hospital. The service needs to be evaluated and revised continuously, so it is hoped that it will draw the attention of other psychiatric inpatient centers and also the mental health organizations of the higher order.
- Subjects
IRAN; DISCHARGE planning; HEALTH planning; PATIENT compliance; MENTAL health facilities; TELEPHONE interviewing
- Publication
Iranian Journal of Psychiatry & Behavioral Sciences / Progress in Psychiatry & Behavioral Sciences, 2018, p160
- ISSN
1735-8639
- Publication type
Article