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Providing the Right Support at the Right Time for People With Learning Disabilities: A Mixed-Methods Study to Identify Change Goals for a Demand, Capacity and Flow Quality Improvement Project
AIMS: 1. To evaluate demand, capacity and flow of an integrated community learning disability service in a peri- and post-COVID-19 pandemic setting. 2. To improve flow of a community learning disability service. 3. To improve staff and service user satisfaction by engaging them and identifying commo...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cambridge University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10345553/ http://dx.doi.org/10.1192/bjo.2023.89 |
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author | Cai, James Barnett, Joshua Haberland, Kirsty Clarke, Melanie Fysh, Grace Chaplin, Catriona Lim, Ivy Martiello, Michele Hall, Ian Checkley, Laura |
author_facet | Cai, James Barnett, Joshua Haberland, Kirsty Clarke, Melanie Fysh, Grace Chaplin, Catriona Lim, Ivy Martiello, Michele Hall, Ian Checkley, Laura |
author_sort | Cai, James |
collection | PubMed |
description | AIMS: 1. To evaluate demand, capacity and flow of an integrated community learning disability service in a peri- and post-COVID-19 pandemic setting. 2. To improve flow of a community learning disability service. 3. To improve staff and service user satisfaction by engaging them and identifying common priorities. METHODS: We collected demand and capacity data of all disciplines in a community learning disability service for 2021–2022. We carried out focus groups with service users and their carers (N = 5) and surveyed them with a questionnaire consisting of 6 quantitative and 2 qualitative questions (N = 63), investigating the impact of waiting times on service user experience. We surveyed staff from all disciplines (N = 20) with a questionnaire consisting of 3 qualitative questions, to identify their views on waiting times and areas to optimise. We performed thematic analysis on all qualitative responses. We analysed quantitative data with descriptive statistics. RESULTS: From 2021–22, the number of accepted referrals to individual disciplines increased: for example referrals to psychiatry increased by 51.6% and referrals to OT increased by 32%. With regard to flow, the ratio of discharges to accepted referrals in the psychiatry discipline decreased from 1.5:1 to 0.6:1. A significant proportion of service users reported waiting months (31%) or years (16%) to be seen by the learning disability team. 28% of service users reported additional problems while waiting to be seen. 31% were unaware whether they were on a waiting list or not. Quantitative data showed average waiting times for psychiatry services did not change from 2021–2022 (23.1 and 23.3 days respectively). Thematic analysis from service users’ responses revealed an anxiety about needs not being met; a feeling of problems deteriorating while waiting; and communication issues. Staff responses revealed desires to intervene sooner to prevent unnecessary deteriorations; and to increase team working between disciplines. CONCLUSION: Quantitative data analysis suggests a greatly increased demand for our service following the COVID-19 pandemic. Our thematic analysis identifies concern of deterioration secondary to prolonged waiting times. It also highlights that communication could be improved. 1. Improve communication with patients on waiting lists by testing an accessible customisable letter. 2. Organise more joint assessments and reviews of service users with multiple disciplines. 3. Short-term allocation of more urgent casework via a new integrated health and social care duty system. |
format | Online Article Text |
id | pubmed-10345553 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Cambridge University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-103455532023-07-15 Providing the Right Support at the Right Time for People With Learning Disabilities: A Mixed-Methods Study to Identify Change Goals for a Demand, Capacity and Flow Quality Improvement Project Cai, James Barnett, Joshua Haberland, Kirsty Clarke, Melanie Fysh, Grace Chaplin, Catriona Lim, Ivy Martiello, Michele Hall, Ian Checkley, Laura BJPsych Open Rapid-Fire Presentations AIMS: 1. To evaluate demand, capacity and flow of an integrated community learning disability service in a peri- and post-COVID-19 pandemic setting. 2. To improve flow of a community learning disability service. 3. To improve staff and service user satisfaction by engaging them and identifying common priorities. METHODS: We collected demand and capacity data of all disciplines in a community learning disability service for 2021–2022. We carried out focus groups with service users and their carers (N = 5) and surveyed them with a questionnaire consisting of 6 quantitative and 2 qualitative questions (N = 63), investigating the impact of waiting times on service user experience. We surveyed staff from all disciplines (N = 20) with a questionnaire consisting of 3 qualitative questions, to identify their views on waiting times and areas to optimise. We performed thematic analysis on all qualitative responses. We analysed quantitative data with descriptive statistics. RESULTS: From 2021–22, the number of accepted referrals to individual disciplines increased: for example referrals to psychiatry increased by 51.6% and referrals to OT increased by 32%. With regard to flow, the ratio of discharges to accepted referrals in the psychiatry discipline decreased from 1.5:1 to 0.6:1. A significant proportion of service users reported waiting months (31%) or years (16%) to be seen by the learning disability team. 28% of service users reported additional problems while waiting to be seen. 31% were unaware whether they were on a waiting list or not. Quantitative data showed average waiting times for psychiatry services did not change from 2021–2022 (23.1 and 23.3 days respectively). Thematic analysis from service users’ responses revealed an anxiety about needs not being met; a feeling of problems deteriorating while waiting; and communication issues. Staff responses revealed desires to intervene sooner to prevent unnecessary deteriorations; and to increase team working between disciplines. CONCLUSION: Quantitative data analysis suggests a greatly increased demand for our service following the COVID-19 pandemic. Our thematic analysis identifies concern of deterioration secondary to prolonged waiting times. It also highlights that communication could be improved. 1. Improve communication with patients on waiting lists by testing an accessible customisable letter. 2. Organise more joint assessments and reviews of service users with multiple disciplines. 3. Short-term allocation of more urgent casework via a new integrated health and social care duty system. Cambridge University Press 2023-07-07 /pmc/articles/PMC10345553/ http://dx.doi.org/10.1192/bjo.2023.89 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. This does not need to be placed under each abstract, just each page is fine. |
spellingShingle | Rapid-Fire Presentations Cai, James Barnett, Joshua Haberland, Kirsty Clarke, Melanie Fysh, Grace Chaplin, Catriona Lim, Ivy Martiello, Michele Hall, Ian Checkley, Laura Providing the Right Support at the Right Time for People With Learning Disabilities: A Mixed-Methods Study to Identify Change Goals for a Demand, Capacity and Flow Quality Improvement Project |
title | Providing the Right Support at the Right Time for People With Learning Disabilities: A Mixed-Methods Study to Identify Change Goals for a Demand, Capacity and Flow Quality Improvement Project |
title_full | Providing the Right Support at the Right Time for People With Learning Disabilities: A Mixed-Methods Study to Identify Change Goals for a Demand, Capacity and Flow Quality Improvement Project |
title_fullStr | Providing the Right Support at the Right Time for People With Learning Disabilities: A Mixed-Methods Study to Identify Change Goals for a Demand, Capacity and Flow Quality Improvement Project |
title_full_unstemmed | Providing the Right Support at the Right Time for People With Learning Disabilities: A Mixed-Methods Study to Identify Change Goals for a Demand, Capacity and Flow Quality Improvement Project |
title_short | Providing the Right Support at the Right Time for People With Learning Disabilities: A Mixed-Methods Study to Identify Change Goals for a Demand, Capacity and Flow Quality Improvement Project |
title_sort | providing the right support at the right time for people with learning disabilities: a mixed-methods study to identify change goals for a demand, capacity and flow quality improvement project |
topic | Rapid-Fire Presentations |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10345553/ http://dx.doi.org/10.1192/bjo.2023.89 |
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