Implementation of hospital care pathways for patients with schizophrenia.
OBJECTIVE
This paper aims to discuss some of the issues for the implementation of care pathways for inpatients suffering from schizophrenia. This paper builds upon a previously published paper describing the development of the care pathway.


BACKGROUND
The use of a care pathway may enable care to be delivered in a more efficient and effective way. Very little is known about the development or implementation of care pathways for mental health conditions.


METHODS
Action research guided the process of implementation and led to 29 in-depth interviews. Participant observation and records of 15 working group meetings rounded the data analysis.


RESULTS
The nature of the study site changed dramatically over the course of the research programme with many staff leaving the ward. This led to many problems in implementing the care pathway including poor levels of morale and engagement; how the patients were admitted and managed on the care pathway; poor levels of documentation.


CONCLUSIONS
The findings are particular to this research environment, although some wider issues could be applicable to other sites such as the nature of representing psychiatric work on the care pathway; the evidence-based practice movement and the role of the user and individualized care.
Jones
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Department of Mental Health Nursing, City University London.
D000328:Adult; D001291:Attitude of Health Personnel; D019091:Critical Pathways / Q000458:organization & administration*; D005260:Female; D006302:Health Services Research; D006801:Humans; D007297:Inpatients; D007902:Length of Stay / Q000706:statistics & numerical data; D008131:London; D008297:Male; D015403:Nursing Evaluation Research; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration*; D010564:Personnel, Hospital / Q000523:psychology* / Q000600:supply & distribution*; D011568:Psychiatric Nursing / Q000458:organization & administration; D012559:Schizophrenia / Q000628:therapy*; D011795:Surveys and Questionnaires