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

ConditionsPsychiatric Hospitalization Coercion Recovery

Trial statusRecruiting

Trial phaseNot listed

Trial typeObservational

Biological sexAll

Age18-65

SponsorUniversity Hospital, Geneva

About this trial

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 criteria

This trial does not accept healthy volunteers

Qualifiers

Patients hospitalized in one of the three participating wards

Disqualifiers

Incapacity to give informed consent

Insufficient knowledge of French

Trial population

All patients admitted to the three participating wards during the study period will be considered for participation. All diagnoses will be included, except for dementia. Patients who are not able to give their written consent to participation and/or with insufficient knowledge of French will be excluded from the study.

Trial design

Design model

Case-control

Time perspective

Prospective

Treatments tested in this trial

New model of psychiatric inpatient care
Other intervention
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.

Treatment groups

700 Participants

are divided into 2 treatment groups

Group A: Intervention group1 intervention

Group B: Control group0 interventions

Trial outcomes