The Psychiatric hospital最新文献

The absence of meaningful linkages between quality assurance programs and quality of care has alienated them from each other, especially in psychiatry, where standards of care and process and outcome of treatment are vaguely defined and vigorously debated. This paper describes several factors contributing to the gap between quality assurance and quality of care as well as a treatment-monitoring process that attempts to bridge the gap. The form and review process described are criteria-based and concurrent, and they use methodology that both assesses documentation and promotes an interactive clinical review. Preliminary data that demonstrate the clinical usefulness of the process and its impact on a treatment service are presented.

This study investigated inter-relationships among nutrition knowledge, habits, and attitudes of psychiatric healthcare providers. Data of nutritional intake was compared with that of the general population of the state of South Carolina, obtained from a previous public health study. Nutritional habits were determined from both a 24-hour recall and a separate three-day recall of dietary intake. Nutrition knowledge and attitudes were determined by validated questionnaires. The knowledge questionnaire consisted of 50 multiple-choice questions. Attitudes were determined using a semantic differential instrument consisting of phrases of descriptive bipolar adjectives. Dietary intake was analyzed using the Food Processor software and compared with the RDAs and with the intake of the general population. Nutrition knowledge was measured by the number of correct responses. Nutrition attitudes were assigned numerical scores and measured by a Likert scale. Only 3 of the subjects met 70% of indicator nutrients (iron, calcium, vitamin B6, and vitamin C). No significant relationships were established among attitudes, habits, and knowledge. Sixty-three percent of subjects perceived themselves as role models to patients, yet 90% of them practiced poor nutrition habits as compared with 97% of the general population. The higher the education level, the more likely that subjects felt nutrition is important for health. A comprehensive nutrition education program is essential for health care providers to promote successful nutrition education for the patients they serve.

A competitive and dynamic healthcare environment requires that psychiatric hospital administrators and physicians continually monitor their hospital's ability to deliver quality services to their patients. To ensure that hospitals stand for and abide by psychiatric hospital practice ethics, the National Association of Private Psychiatric Hospitals (NAPPH) Board of Trustees has formally approved and distributed to the industry a "Statement of Principles of Psychiatric Hospital Practice Ethics." Adopted at the June 22, 1989, Board meeting, the guidelines not only summarize views long held in the industry, but are a condition of NAPPH membership. Nine critical areas are identified in the NAPPH statement: admissions, advertising, marketing and referral development, resource allocation and appropriateness of care, treatment rendered, patients' rights, family rights and involvement, competition, and financial resources. Central to ethical hospital practice is a moral responsibility--shared among administrators, trustees, physicians and staff--to ensure access to care, quality of care, and fair treatment of patients. NAPPH represents more than 300 private psychiatric hospitals throughout the United States, and the NAPPH mission includes the promotion of high-quality care and treatment, efficient hospital operation, and advocacy for the patients served by its member hospitals. Each NAPPH hospital actively supports the appropriate, safe, and compassionate treatment of the mentally ill.

A retrospective study of 113 adolescent patients admitted to a short-term unit revealed that family history of drug abuse, behavior problems in females, history of previous inpatient hospitalization diagnosed under a DSM-III category of disorders usually first evident in childhood or adolescence, grade level, symptom of drug experimentation, elopement, and family involvement in treatment were significant variables distinguishing the patients who returned to the community at the end of short-term stay versus those who required continued treatment in a structured residential setting.

Crisis residential programs were established by the California legislature in 1978 to provide an alternative to hospitalization for treatment of voluntary acute psychiatric patients. The five crisis residential programs in San Diego County, California, provide high-quality mental health care that is community-based and considerably less expensive than traditional in-hospital programs. Currently, the majority of public-sector, voluntary adult patients in San Diego County receives acute psychiatric inpatient services in these programs. This paper provides a description of the facilities, staff composition, patients, treatment model, and costs.

The last decade has seen an enormous increase in the use of business techniques in the ownership and operation of psychiatric hospitals. Many physicians have reacted negatively to these developments and have raised many concerns about their impact on patient care. However, commercialism in hospitals is not new. Certain key business values, including attention to a guiding mission statement, the needs of consumers, accountability, and marketing, have a positive impact on the quality of milieu treatment.

This paper presents the findings of a study comparing disparate hospital outcomes of a young adult population. Clinical ratings of much improved and unimproved status at the time of discharge were our outcome variables. Major differences in patient characteristics associated with improvement status related to age of onset of disorder and premorbid functioning. Hospital variables yielding significant differences between the cohorts included treatment alliance on the part of patients and families, reduction in symptomatology, and diagnostic classifications. A discriminant function analysis was carried out to identify the combination of variables contributing the most to the variance. Directions for further study are explored.

The National Association of Private Psychiatric Hospitals has been surveying hospitals for the past several years. This paper focuses on the salary levels and average annual rates of increase for a few selected positions. Comparisons are made with data from surveys covering similar positions in other settings and with the Consumer Price Index. Annual rates of increase are reported for five- and ten-year periods.