RecruitingNCT06250296

Evaluation of a New Recovery-oriented Model of Psychiatric Inpatient Care

Evaluation of a New Recovery-oriented Model of Care on Psychiatric Inpatient Wards.

Sponsor

University Hospital, Geneva

Enrollment

700 participants

Start Date

Feb 15, 2024

Study Type

OBSERVATIONAL

Conditions

Recovery Psychiatric Hospitalization Coercion

Summary

This project will study the effects of a major reorganization of psychiatric inpatient wards. This reorganization will affect many aspects of day-to-day work, with the aim of improving the individualization of care, the integration of relatives and the participation of the patients in treatment planning. This new organization will initially involve a first pilot ward, before being extended to other wards. The aim of this project is to understand whether this new organization has positive effects on the use of coercive measures, the average length of stay, the improvement in patients' clinical condition, as well as on patient satisfaction, their perception of coercion, the wards' atmosphere on the unit and patients' personal recovery. All patients admitted to three wards of the Division of adult psychiatry of the Geneva University Hospital aged 18 and over, with a good knowledge of French and being treated for any type of diagnosis except dementia, are invited to take part in the study. They will be assessed at discharge regarding the selected outcomes. The study will last 18 months: during the first 9 months, the new model will be applied on the pilot ward, and the wo other wards will serve as comparison wards. After 9 months, the model will also be applied to these other two wards.

Eligibility

Min Age: 18 YearsMax Age: 65 Years

Inclusion Criteria1

Patients hospitalized in one of the three participating wards

Exclusion Criteria2

Incapacity to give informed consent
Insufficient knowledge of French

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Interventions

OTHERNew model of psychiatric inpatient care

The intervention envisages major structural changes in wards, in particular the reorganization of clinical discussion and decision-making spaces, as well as the medical and nursing referral system, and the inclusion of relatives in care: * Treatment planning involving the patient, with a focus on his or her needs and resources. * Care by referral teams, present every day of the week, to ensure continuity and consistency of care. * As few decisions as possible made without the patient, and transparency in decision-making. * Emphasis on the subjective meaning of illness, beyond symptoms. * Greater visibility of care planning for patients, who will benefit from weekly agendas * Closer collaboration with relatives, through open invitations to all clinical discussions, telephone hotlines and meeting times. * Openness to the network and community care, by promoting communication and exchanges between all stakeholders, and the development of early warning tools such as the joint crisis plan.