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

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@article{4ced529b39cc4195ba4ba91158df51d7,
title = "Developing Best Practice Guidance for Discharge Planning Using the RAND/UCLA Appropriateness Method",
abstract = "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.",
keywords = "best practice, care transitions, consensus methods, discharge planning, inpatient, mental health, RAND",
author = "Natasha Tyler and Claire Planner and Matthew Byrne and Thomas Blakeman and Keers, {Richard N.} and Oliver Wright and {Pascall Jones}, Paul and Sally Giles and Chris Keyworth and Alexander Hodkinson and Christopher Taylor and Armitage, {Christopher J.} and Stephen Campbell and Maria Panagioti",
note = "Funding Information: This work was funded by the National Institute for Health Research (NIHR) Greater Manchester Patient Safety Translational Research Centre (award number: PSTRC-2016-003). Publisher Copyright: Copyright {\textcopyright} 2021 Tyler, Planner, Byrne, Blakeman, Keers, Wright, Pascall Jones, Giles, Keyworth, Hodkinson, Taylor, Armitage, Campbell and Panagioti.",
year = "2021",
month = dec,
day = "3",
doi = "10.3389/fpsyt.2021.789418",
language = "English",
volume = "12",
journal = "Frontiers in Psychiatry",
issn = "1664-0640",
publisher = "Frontiers Media S. A.",

}

RIS

TY - JOUR

T1 - Developing Best Practice Guidance for Discharge Planning Using the RAND/UCLA Appropriateness Method

AU - Tyler, Natasha

AU - Planner, Claire

AU - Byrne, Matthew

AU - Blakeman, Thomas

AU - Keers, Richard N.

AU - Wright, Oliver

AU - Pascall Jones, Paul

AU - Giles, Sally

AU - Keyworth, Chris

AU - Hodkinson, Alexander

AU - Taylor, Christopher

AU - Armitage, Christopher J.

AU - Campbell, Stephen

AU - Panagioti, Maria

N1 - Funding Information: This work was funded by the National Institute for Health Research (NIHR) Greater Manchester Patient Safety Translational Research Centre (award number: PSTRC-2016-003). Publisher Copyright: Copyright © 2021 Tyler, Planner, Byrne, Blakeman, Keers, Wright, Pascall Jones, Giles, Keyworth, Hodkinson, Taylor, Armitage, Campbell and Panagioti.

PY - 2021/12/3

Y1 - 2021/12/3

N2 - 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.

AB - 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.

KW - best practice

KW - care transitions

KW - consensus methods

KW - discharge planning

KW - inpatient

KW - mental health

KW - RAND

UR - http://dx.doi.org/10.3389/fpsyt.2021.789418

U2 - 10.3389/fpsyt.2021.789418

DO - 10.3389/fpsyt.2021.789418

M3 - Article

C2 - 34925112

VL - 12

JO - Frontiers in Psychiatry

JF - Frontiers in Psychiatry

SN - 1664-0640

M1 - 789418

ER -