Clinical decision making for discharge planning in a changing psychiatric environment.
This article reviews the clinical decision-making process involved in planning for continuity of care following discharge from inpatient psychiatric services. The decision-making frame of reference requires the identification of the players in the process, parameters of their roles, performance expectations, and boundaries of rights and obligations; clear definition of objectives; collection of data and analysis of its relevancy; and study of possible alternatives, with evaluations of their consequences. The authors present an approach to clinical decision making that includes an analysis of modalities and practice skills and a critical review of practice in a psychiatric setting that emphasizes the role of the family; the importance of continuity of care; and the need to engage the patient, family, and care systems within briefer time frames.
Tuzman
L
L
Department of Social Work Services, Hillside Hospital/Long Island Jewish Medical Center, New Hyde Park, NY 11042.
Cohen
A
A
D000328:Adult; D003266:Continuity of Patient Care / Q000458:organization & administration*; D003657:Decision Making; D003688:Deinstitutionalization; D006778:Hospitals, Psychiatric / Q000458:organization & administration*; D006801:Humans; D008297:Male; D010351:Patient Discharge; D012563:Schizophrenia, Paranoid / Q000175:diagnosis / Q000534:rehabilitation*; D012947:Social Work / Q000458:organization & administration