Developing Best Practice Guidance for Discharge Planning Using the RAND/UCLA Appropriateness Method

Background: Discharge from acute mental health inpatient units is often a vulnerable period for patients. Multiple professionals and agencies are involved and processes and procedures are not standardized, often resulting in communication delays and co-ordination failures. Early and appropriate disc...

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Autores principales:	Natasha Tyler, Claire Planner, Matthew Byrne, Thomas Blakeman, Richard N. Keers, Oliver Wright, Paul Pascall Jones, Sally Giles, Chris Keyworth, Alexander Hodkinson, Christopher D. J. Taylor, Christopher J. Armitage, Stephen Campbell, Maria Panagioti
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	mental health RAND discharge planning care transitions best practice consensus methods Psychiatry RC435-571
Acceso en línea:	https://doaj.org/article/8fe3b86b3a96442e8c8b75207277e8b3
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spelling	oai:doaj.org-article:8fe3b86b3a96442e8c8b75207277e8b32021-12-03T15:10:56ZDeveloping Best Practice Guidance for Discharge Planning Using the RAND/UCLA Appropriateness Method1664-064010.3389/fpsyt.2021.789418https://doaj.org/article/8fe3b86b3a96442e8c8b75207277e8b32021-12-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fpsyt.2021.789418/fullhttps://doaj.org/toc/1664-0640Background: Discharge from acute mental health inpatient units is often a vulnerable period for patients. Multiple professionals and agencies are involved and processes and procedures are not standardized, often resulting in communication delays and co-ordination failures. Early and appropriate discharge planning and standardization of procedures could make inpatient care safer.Aim: To inform the development of a multi-component best practice guidance for discharge planning (including the 6 component SAFER patient flow bundle) to support safer patient transition from mental health hospitals to the community.Methods: Using the RAND/UCLA Appropriateness method, a panel of 10 professional stakeholders (psychiatrists, psychiatric nurses, clinical psychologists, pharmacists, academics, and policy makers) rated evidence-based statements. Six hundred and sixty-eight statements corresponding to 10 potential components of discharge planning best practice were rated on a 9-point integer scale for clarity, appropriateness and feasibility (median ≥ 7–9) using an online questionnaire then remote online face-to-face meetings.Results: Five of the six “SAFER” patient flow bundle components were appropriate and feasible for inpatient mental health. One component, “Early Flow,” was rated inappropriate as mental health settings require more flexibility. Overall, 285 statements were rated as appropriate and feasible. Forty-four statements were considered appropriate but not feasible to implement.Discussion: This consensus study has identified components of a best practice guidance/intervention for discharge planning for UK mental health settings. Although some components describe processes that already happen in everyday clinical interactions (i.e., review by a senior clinician), standardizing such processes could have important safety benefits alongside a tailored and timely approach to post-discharge care.Natasha TylerNatasha TylerClaire PlannerMatthew ByrneThomas BlakemanRichard N. KeersRichard N. KeersOliver WrightPaul Pascall JonesSally GilesChris KeyworthAlexander HodkinsonChristopher D. J. TaylorChristopher D. J. TaylorChristopher J. ArmitageChristopher J. ArmitageChristopher J. ArmitageChristopher J. ArmitageStephen CampbellStephen CampbellMaria PanagiotiMaria PanagiotiFrontiers Media S.A.articlemental healthRANDdischarge planningcare transitionsbest practiceconsensus methodsPsychiatryRC435-571ENFrontiers in Psychiatry, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	mental health RAND discharge planning care transitions best practice consensus methods Psychiatry RC435-571
spellingShingle	mental health RAND discharge planning care transitions best practice consensus methods Psychiatry RC435-571 Natasha Tyler Natasha Tyler Claire Planner Matthew Byrne Thomas Blakeman Richard N. Keers Richard N. Keers Oliver Wright Paul Pascall Jones Sally Giles Chris Keyworth Alexander Hodkinson Christopher D. J. Taylor Christopher D. J. Taylor Christopher J. Armitage Christopher J. Armitage Christopher J. Armitage Christopher J. Armitage Stephen Campbell Stephen Campbell Maria Panagioti Maria Panagioti Developing Best Practice Guidance for Discharge Planning Using the RAND/UCLA Appropriateness Method
description	Background: Discharge from acute mental health inpatient units is often a vulnerable period for patients. Multiple professionals and agencies are involved and processes and procedures are not standardized, often resulting in communication delays and co-ordination failures. Early and appropriate discharge planning and standardization of procedures could make inpatient care safer.Aim: To inform the development of a multi-component best practice guidance for discharge planning (including the 6 component SAFER patient flow bundle) to support safer patient transition from mental health hospitals to the community.Methods: Using the RAND/UCLA Appropriateness method, a panel of 10 professional stakeholders (psychiatrists, psychiatric nurses, clinical psychologists, pharmacists, academics, and policy makers) rated evidence-based statements. Six hundred and sixty-eight statements corresponding to 10 potential components of discharge planning best practice were rated on a 9-point integer scale for clarity, appropriateness and feasibility (median ≥ 7–9) using an online questionnaire then remote online face-to-face meetings.Results: Five of the six “SAFER” patient flow bundle components were appropriate and feasible for inpatient mental health. One component, “Early Flow,” was rated inappropriate as mental health settings require more flexibility. Overall, 285 statements were rated as appropriate and feasible. Forty-four statements were considered appropriate but not feasible to implement.Discussion: This consensus study has identified components of a best practice guidance/intervention for discharge planning for UK mental health settings. Although some components describe processes that already happen in everyday clinical interactions (i.e., review by a senior clinician), standardizing such processes could have important safety benefits alongside a tailored and timely approach to post-discharge care.
format	article
author	Natasha Tyler Natasha Tyler Claire Planner Matthew Byrne Thomas Blakeman Richard N. Keers Richard N. Keers Oliver Wright Paul Pascall Jones Sally Giles Chris Keyworth Alexander Hodkinson Christopher D. J. Taylor Christopher D. J. Taylor Christopher J. Armitage Christopher J. Armitage Christopher J. Armitage Christopher J. Armitage Stephen Campbell Stephen Campbell Maria Panagioti Maria Panagioti
author_facet	Natasha Tyler Natasha Tyler Claire Planner Matthew Byrne Thomas Blakeman Richard N. Keers Richard N. Keers Oliver Wright Paul Pascall Jones Sally Giles Chris Keyworth Alexander Hodkinson Christopher D. J. Taylor Christopher D. J. Taylor Christopher J. Armitage Christopher J. Armitage Christopher J. Armitage Christopher J. Armitage Stephen Campbell Stephen Campbell Maria Panagioti Maria Panagioti
author_sort	Natasha Tyler
title	Developing Best Practice Guidance for Discharge Planning Using the RAND/UCLA Appropriateness Method
title_short	Developing Best Practice Guidance for Discharge Planning Using the RAND/UCLA Appropriateness Method
title_full	Developing Best Practice Guidance for Discharge Planning Using the RAND/UCLA Appropriateness Method
title_fullStr	Developing Best Practice Guidance for Discharge Planning Using the RAND/UCLA Appropriateness Method
title_full_unstemmed	Developing Best Practice Guidance for Discharge Planning Using the RAND/UCLA Appropriateness Method
title_sort	developing best practice guidance for discharge planning using the rand/ucla appropriateness method
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/8fe3b86b3a96442e8c8b75207277e8b3
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Developing Best Practice Guidance for Discharge Planning Using the RAND/UCLA Appropriateness Method

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