Network coordination following discharge from psychiatric inpatient treatment: a study protocol

Agnes Von Wyl,Nicolas Rüsch,Gisela Heim,Wulf Rössler,Andreas Andreae

doi:10.1186/1471-244x-13-220

Abstract

BackgroundInadequate discharge planning following inpatient stays is a major issue in the provision of a high standard of care for patients who receive psychiatric treatment. Studies have shown that half of patients who had no pre-discharge contact with outpatient services do not keep their first outpatient appointment. Additionally, discharged patients who are not well linked to their outpatient care networks are at twice the risk of re-hospitalization. The aim of this study is to investigate if the Post-Discharge Network Coordination Program at ipw has a demonstrably significant impact on the frequency and duration of patient re-hospitalization. Subjects are randomly assigned to either the treatment group or to the control group. The treatment group participates in the Post-Discharge Network Coordination Program. The control group receives treatment as usual with no additional social support. Further outcome variables include: social support, change in psychiatric symptoms, quality of life, and independence in daily functioning.Methods/designThe study is conducted as a randomized controlled trial. Subjects are randomly assigned to either the control group or to the treatment group. Computer generated block randomization is used to assure both groups have the same number of subjects. Stratified block randomization is used for the psychiatric diagnosis of ICD-10, F1. Approximately 160 patients are recruited in two care units at Psychiatrie-Zentrum Hard Embrach and two care units at Klinik Schlosstal Winterthur.DiscussionThe proposed post-discharge network coordination program intervenes during the critical post-discharge period. It focuses primarily on promoting the integration of the patients into their social networks, and additionally to coordinating outpatient care and addressing concerns of daily life.Trial registrationISRCTN: ISRCTN58280620

Highlights

Inadequate discharge planning following inpatient stays is a major issue in the provision of a high standard of care for patients who receive psychiatric treatment
Research question The main objective of this study is to investigate if the Post-Discharge Network Coordination Program (PDNC-P) achieves a reduction in the number of inpatient days between discharge and one-year follow-up
Since the first weeks following inpatient treatment are very stressful for psychiatric patients and associated with a higher suicide risk [2], systematically planning discharge is very important

Summary

Introduction

Inadequate discharge planning following inpatient stays is a major issue in the provision of a high standard of care for patients who receive psychiatric treatment. Discharged patients who are not well linked to their outpatient care networks are at twice the risk of re-hospitalization. The aim of this study is to investigate if the Post-Discharge Network Coordination Program at ipw has a demonstrably significant impact on the frequency and duration of patient re-hospitalization. The treatment group participates in the Post-Discharge Network Coordination Program. The control group receives treatment as usual with no additional social support. The number of psychiatric inpatient beds has been reduced, and the duration of psychiatric hospitalizations has decreased [1]. The first six weeks after discharge from inpatient psychiatric care represent a very stressful period for patients. There is evidence that suicide risk is greatly increased during this time, especially following a short psychiatric

Objectives

Methods

Findings

Conclusion