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How to measure staff continuity in intensive psychiatric home treatment: a routine data and single case analysis

BACKGROUND: Intensive forms of outreach mental health care (IOC) such as crisis resolution or home treatment teams are increasingly implemented as alternatives to inpatient admission, providing recovery-oriented treatment at home at comparable costs and outcomes. However, one issue with IOC is the l...

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Autores principales: Schwarz, Julian, Wolff, Jan, Heinze, Martin, von Peter, Sebastian, Habicht, Juri Luis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204706/
https://www.ncbi.nlm.nih.gov/pubmed/37229387
http://dx.doi.org/10.3389/fpsyt.2023.1166197
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author Schwarz, Julian
Wolff, Jan
Heinze, Martin
von Peter, Sebastian
Habicht, Juri Luis
author_facet Schwarz, Julian
Wolff, Jan
Heinze, Martin
von Peter, Sebastian
Habicht, Juri Luis
author_sort Schwarz, Julian
collection PubMed
description BACKGROUND: Intensive forms of outreach mental health care (IOC) such as crisis resolution or home treatment teams are increasingly implemented as alternatives to inpatient admission, providing recovery-oriented treatment at home at comparable costs and outcomes. However, one issue with IOC is the lack of continuity regarding staff members who provide home visits, complicating relationship building and meaningful therapeutic exchange. The aim of this study is to validate existing primarily qualitative findings using performance data and to explore a possible correlation between the number of staff involved within IOC treatment and the service users’ length of stay (LOS). METHODS: Routine data from an IOC team in a catchment area in Eastern Germany were analyzed. Basic parameters of service delivery were calculated and an in-depth descriptive analysis regarding staff continuity was performed. Further, an exploratory single case analysis was conducted, presenting the exact sequence of all treatment contacts for one case with low and one with high staff continuity. RESULTS: We analyzed 10.598 face-to-face treatment contacts based on 178 IOC users. The mean LOS was 30.99 days. About 75% of all home visits were conducted by two or more staff members simultaneously. Service users saw an average of 10.24 different staff per treatment episode. On 11% of the care days, only unknown staff, and on 34% of the care days at least one unknown staff member conducted the home visit. 83% of the contacts were performed by the same three staff members and 51% were made by one and the same staff member. A significant positive correlation (p = 0.0007) was found between the number of different practitioners seen by a service user in the first seven days of care and the LOS. CONCLUSION: Our results suggest that a high number of different staff in the early period of IOC episodes correlates with an extended LOS. Future research must clarify the exact mechanisms of this correlation. Furthermore, it should be investigated how the multiple professions within IOC teams influence the LOS and the quality of treatment and what quality indicators may be suitable to ensure treatment processes.
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spelling pubmed-102047062023-05-24 How to measure staff continuity in intensive psychiatric home treatment: a routine data and single case analysis Schwarz, Julian Wolff, Jan Heinze, Martin von Peter, Sebastian Habicht, Juri Luis Front Psychiatry Psychiatry BACKGROUND: Intensive forms of outreach mental health care (IOC) such as crisis resolution or home treatment teams are increasingly implemented as alternatives to inpatient admission, providing recovery-oriented treatment at home at comparable costs and outcomes. However, one issue with IOC is the lack of continuity regarding staff members who provide home visits, complicating relationship building and meaningful therapeutic exchange. The aim of this study is to validate existing primarily qualitative findings using performance data and to explore a possible correlation between the number of staff involved within IOC treatment and the service users’ length of stay (LOS). METHODS: Routine data from an IOC team in a catchment area in Eastern Germany were analyzed. Basic parameters of service delivery were calculated and an in-depth descriptive analysis regarding staff continuity was performed. Further, an exploratory single case analysis was conducted, presenting the exact sequence of all treatment contacts for one case with low and one with high staff continuity. RESULTS: We analyzed 10.598 face-to-face treatment contacts based on 178 IOC users. The mean LOS was 30.99 days. About 75% of all home visits were conducted by two or more staff members simultaneously. Service users saw an average of 10.24 different staff per treatment episode. On 11% of the care days, only unknown staff, and on 34% of the care days at least one unknown staff member conducted the home visit. 83% of the contacts were performed by the same three staff members and 51% were made by one and the same staff member. A significant positive correlation (p = 0.0007) was found between the number of different practitioners seen by a service user in the first seven days of care and the LOS. CONCLUSION: Our results suggest that a high number of different staff in the early period of IOC episodes correlates with an extended LOS. Future research must clarify the exact mechanisms of this correlation. Furthermore, it should be investigated how the multiple professions within IOC teams influence the LOS and the quality of treatment and what quality indicators may be suitable to ensure treatment processes. Frontiers Media S.A. 2023-05-09 /pmc/articles/PMC10204706/ /pubmed/37229387 http://dx.doi.org/10.3389/fpsyt.2023.1166197 Text en Copyright © 2023 Schwarz, Wolff, Heinze, von Peter and Habicht. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Schwarz, Julian
Wolff, Jan
Heinze, Martin
von Peter, Sebastian
Habicht, Juri Luis
How to measure staff continuity in intensive psychiatric home treatment: a routine data and single case analysis
title How to measure staff continuity in intensive psychiatric home treatment: a routine data and single case analysis
title_full How to measure staff continuity in intensive psychiatric home treatment: a routine data and single case analysis
title_fullStr How to measure staff continuity in intensive psychiatric home treatment: a routine data and single case analysis
title_full_unstemmed How to measure staff continuity in intensive psychiatric home treatment: a routine data and single case analysis
title_short How to measure staff continuity in intensive psychiatric home treatment: a routine data and single case analysis
title_sort how to measure staff continuity in intensive psychiatric home treatment: a routine data and single case analysis
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204706/
https://www.ncbi.nlm.nih.gov/pubmed/37229387
http://dx.doi.org/10.3389/fpsyt.2023.1166197
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