scholarly journals Service innovations: the eCPA

2002 ◽  
Vol 26 (7) ◽  
pp. 266-268 ◽  
Author(s):  
Roger Howells ◽  
Amanda Thompsell
Keyword(s):  
Good Practice ◽  
Community Mental Health Team ◽  
Quality Of Information ◽  
Care Programme ◽  
Mental Health Team ◽  
Care Plans ◽  
Computer Based ◽  
Future Potential ◽  
First Time

This paper describes the implementation, merits and future potential of the eCPA – a computer-based Care Programme Approach (CPA) system for care planning. The system is designed to improve the quality of information in CPA care plans and, for the first time, to enable the rapid and standardised adoption of evidence-based good practice by all community mental health team (CMHT) staff.

scholarly journals The clinical complexity of cases of schizophrenia in a community mental health team: a 3 year comparison

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S340-S340
Author(s):  
Shay-Anne Pantall ◽  
Laxsan Karunanithy ◽  
Hayley Boden ◽  
Lisa Brownell
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Community Mental Health ◽  
List Type ◽  
Community Mental Health Team ◽  
Service Usage ◽  
Care Programme ◽  
Mental Health Team ◽  
Health Team ◽  
Long Acting

AimsTo describe the changes in complexity and management of individuals with schizophrenia in a community mental health team (CMHT) over a three year period.BackgroundIt is often believed that individuals receiving care from CMHTs are those with low levels of complexity and risk, and are relatively stable, with more complex individuals being managed by assertive outreach or other specialist teams. Here, we describe changes in the complexity, comorbidity, service-usage and management, of patients with a diagnosis of schizophrenia in a CMHT between 2016 and 2019.MethodData were collected from an electronic patient record system (RiO) for all individuals with schizophrenia in a CMHT in Birmingham (n = 84 in 2016, n = 71 in 2019), examining demographic variables, comorbidity, use of mental health services and current management.ResultKey findings included: - •63% were managed through care programme approach (CPA) in 2016, compared to only 31% in 2019.•21% had required home treatment or inpatient care in the preceding 12 months in 2016; this had improved to 8.5% in 2019.•Significant levels of psychiatric comorbidity, including addictions with almost half of patients (46.5%) having a known history of substance use in 2019, compared to only 15.5% noted in 2016.•Pharmacological management has remained broadly similar; in 2016 21% patients were taking a combination of 2 antipsychotics compared to only 10% in 2019 and 25% were taking clozapine in 2016 (21% in 2019). 39% were prescribed a long acting antipsychotic injection in 2016, compared to 32% in 2019.•In 2016, medication was being prescribed in the majority of cases within secondary care (55%) patients and in primary care in only 21%. GPs have now taken on greater prescribing responsibility in 2019, prescribing in 44% of cases, with 47% being prescribed by the CMHT.ConclusionThe acuity and management of individuals with a diagnosis of schizophrenia under the care of a CMHT has changed over a 3 year period. It is positive to note the reduced use of crisis services and lower rates of polypharmacy. There is a reduction in the proportion of patients receiving management through CPA, and a move towards more medication being prescribed in primary care. The reasons for this change are however unclear and may reflect change in available resources, given that more than half of this group receive clozapine or long acting injections, and have high levels of comorbidity.

scholarly journals Non-financial corporations in Lebanon: Who governs? “The governance myopia”

2016 ◽  
Vol 14 (1) ◽  
pp. 84-95 ◽  
Author(s):  
Mireille Chidiac El Hajj ◽  
Richard Abou Moussa ◽  
Maha Akiki ◽  
Anthony Sassine
Keyword(s):  
Capital Market ◽  
Stock Exchange ◽  
Board Members ◽  
Exchange Market ◽  
Quality Of Information ◽  
Face To Face ◽  
Governance Practices ◽  
First Time

The purpose of this paper is to study governance practices in non-financial enterprises in Lebanon, and it is the first time that such enterprises are studied in the Lebanese context. Only three non-financial institutions are listed in the Beirut Stock Exchange (BSE), which constitute the whole population of this research. Built on Principles, Governance is based on transparency and on accurate, relevant, and timely information in order to support the Board members’ decision-making (OECD, 2015). Balanced between Jensen and Meckling’s (1976) agency theory and Donaldson and Davis’ (1991) Stewardship theory, the results of our Qualitative study showed that the main problems faced by the enterprises are not in the quality of information but rather in its selection and filtering, which opens doors to “Governance Myopia”. Face-to-face interviews showed that the primary conflict in our case is between the non-financial enterprises and the BSE, since the BSE is controlled by the enterprises and is not controlling them. The main reason of such practices come from the fear of the BSE of losing a potential position in the MENA Exchange Market, doubled with the fear of losing potential investors. All these reasons weigh heavily on the Administrators of the BSE in Lebanon, forcing them to choose the “Laisser passer” way. Referring to the soft Law when dealing with the companies, the BSE is playing the double role of a marketer and a controller, thus not willing to impose restrictions. A need for “harder laws”, for “Privatization” of the BSE, and a call to the Capital Market Authority (CMA) to put more restrictions on Corporations should be observed.

scholarly journals Using evidence-based dissemination and implementation strategies to improve routine communication between general practitioners and community mental health teams

2004 ◽  
Vol 28 (1) ◽  
pp. 8-11 ◽  
Author(s):  
Tracy White ◽  
Sarah Marriott
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
General Practitioners ◽  
Good Practice ◽  
Implementation Strategies ◽  
Dissemination And Implementation ◽  
Care Providers ◽  
Mental Health Team ◽  
Clinical Communication

Aims and MethodTo improve the quality of written communication between general practitioners (GPs) and community mental health team (CMHT) members concerning patients newly referred to two inner-city CMHTs. Following a benchmark audit of a random sample of referral and assessment letters, locally agreed good practice protocols were shared widely, accompanied by a dissemination and implementation strategy.ResultsSignificant improvements occurred in both GP and CMHT letters; these were most dramatic after 1 year, but tailed off considerably in the second year despite continued efforts to implement the protocols' standards.Clinical ImplicationsPlanned dissemination and implementation strategies can help to improve routine clinical communication between CMHTs and GPs through the use of good practice protocols, thus improving shared working between primary and secondary care providers.

scholarly journals e-Health: A New Approach in Healthcare Practice

2003 ◽  
Author(s):  
Vinod Podichetty ◽  
Robert Biscup
Keyword(s):  
Healthcare Professionals ◽  
The Internet ◽  
Quality Of Information ◽  
New Approach ◽  
Knowledge Based ◽  
The World ◽  
Healthcare Practice ◽  
First Time ◽  
The Web

The Internet offers an unprecedented opportunity for healthcare information to be disseminated instantaneously. Quality of information, both scientific and nonscientific, and the development of tools to disseminate information securely via the Internet are the two most important issues related to achieving effective and wider exchange of health information. For the first time ever, information can be exchanged simultaneously and interactively all around the world, with the potential of being equally available to healthcare professionals as well as to patients. The big difference between yesterday's knowledge-based patient care and that of tomorrow, is a fundamental premise that patients will explore the web world with a desire to learn more about their condition, including its treatment and prognosis. This has evolved into the concept of e-health (Electronic Health). Evaluation and examination of the information being conveyed via the Internet is important and necessary in order for the Internet to be an effective tool in healthcare.

scholarly journals Quality standards for community mental health teams

2009 ◽  
Vol 33 (10) ◽  
pp. 387-389 ◽  
Author(s):  
Richard Laugharne ◽  
Rohit Shankar
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Local Community ◽  
Evidence Based ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Team Members ◽  
Health Team ◽  
Staff Performance

SummaryThere is an increasing requirement for mental health services to demonstrate the quality of care provided. We have developed a quality report of our local community mental health team in Cornwall and suggest quality measures that we believe are useful to patients and clinicians, and possible to implement without overwhelming busy team members. They include measures of satisfaction, accessibility, safe process and review, outcomes, evidence-based practice and staff performance. Different teams may need different standards but we hope this paper will stimulate discussion and debate.

scholarly journals Physical health monitoring of patients prescribed depot antipsychotic medication in north west Edinburgh community mental health team

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S336-S337
Author(s):  
Douglas Murdie ◽  
Jakub Wojtowicz ◽  
Alexandra Thompson ◽  
Anne MacLeod ◽  
Adam Mallis ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Antipsychotic Medication ◽  
Health Monitoring ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
North West ◽  
Depot Antipsychotic ◽  
Major Mental Disorder

AimsTo monitor the quality of physical health monitoring of patients prescribed depot antipsychotic medication in the North West Edinburgh Community Mental Health Team (CMHT). We also evaluated the completeness of prescriptions and Mental Health Act (Scotland) (Act) 2003 paperwork where relevant.BackgroundAntipsychotic medications are medicines for treating conditions such as Schizophrenia, but some may be associated with an increased risk of Metabolic Syndrome. Moreover, evidence indicates that patients with major mental disorder have a reduced life expectancy in comparison to those without such diagnoses. These two factors illustrate the importance of the physical health of this patient cohort being monitored on a regular basis. This project will evaluate how a local CMHT is performing, with the possibility of enacting service improvements if required.MethodThe records of the 60 patients prescribed depot antipsychotic medication administered by this CMHT were reviewed. A check-list was created consisting of 14 categories analysing the quality of physical health monitoring, as well as compliance with prescription standards and, where relevant, Mental Health Act (Scotland) (Act) 2003 paperwork. We compared patient records against our checklist for the calendar year of 2019. The Scottish Intercollegiate Guidelines Network (SIGN) 131 (Management of Schizophrenia) section 5.2 was used as the gold standard for physical health monitoring against which the data we collected was compared.ResultWe identified a wide range of flaws with the current system and implementation of monitoring, and difficulty in locating the required information. There was no consistent monitoring of physical observations on electronic record, nor an accepted alternative way in which this was documented. Furthermore, blood tests were not consistently obtained either by the service or GP practices in a reproducible manner. This led to discussions within the CMHT regarding creation of a new pathway for the monitoring of this patient cohort using a Quality Improvement model, with the ultimate goal to establish a regular physical health clinic.ConclusionThere is significant evidence that patients with major mental disorder do not access healthcare as consistently as those without, leading to a disparity in life expectancy. In light of the fact that antipsychotic medications can be associated with Metabolic Syndrome, we have an even greater responsibility to tackle this marked health inequality by appropriately monitoring our patients. This was not done well in this particular CMHT, but this project will lead to improvements in the service and ultimately patient care.

scholarly journals Improving methods of assessment in a community mental health team

1996 ◽  
Vol 20 (1) ◽  
pp. 30-32 ◽  
Author(s):  
Adrian Treloar
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Clinical Information ◽  
The Elderly ◽  
Case Note ◽  
Dramatic Improvement ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team

Changing methods of recording psychiatric histories by a community mental health team for the elderly was associated with a dramatic improvement in the quality of recording of clinical Information and of communication with general practitioners. Comparison is made with published studies of case note audit with feedback. It is suggested that restructuring the way we work may be more effective than simple review of case notes with feedback.

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