Perceptions on the development of a care pathway for people diagnosed with schizophrenia on acute psychiatric units.
Policy development and practice for hospital mental health care has shifted towards a user-focused and evidence-based direction. Important within this policy development has been a guideline for inpatient care, particularly the establishment of an inpatient Acute Care Forum. A vehicle to both commission and develop this agenda is the Implementation of a care pathway. A research study was designed to explore how a care pathway could be developed for inpatients diagnosed with schizophrenia. Interviews with a range of health care professionals and observation of the process of care pathway development were the data-collection tools. Analysis was driven by emergent themes across the data set. Themes were then presented as one possible interpretation of the factors to be considered for the development of a care pathway for people diagnosed with schizophrenia. Clinicians experienced many difficulties in finding and including evidence-based practice (EBP) within a care pathway. Professions on the whole felt that there was a certain futility to psychiatric care given the paucity of evidence to support practice. This may contribute towards the poor use of hospital care as a therapeutic intervention as part of the wider spectrum of care. Difficulties arise when trying to develop a care pathway with EBP, given the paucity of knowledge on why certain interventions are only partially effective. The development of a care pathway may inform the priorities of the inpatient Acute Care Forum for people diagnosed with schizophrenia. A care pathway should not be constrained, however, to EBP and should incorporate therapeutic activities to improve the overall experience of service users. Limitations on the study and the collection of evidence supporting these conclusions conclude the paper.
Clinical Services Manager, Mental Health Directorate, North East Wales NHS Trust, Wrexham. Adrian.Jones@new-tr.wales.nhs.uk
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D001291:Attitude of Health Personnel; D019091:Critical Pathways; D004739:England; D019317:Evidence-Based Medicine; D006801:Humans; D009936:Organizational Innovation; D016730:Program Development; D011567:Psychiatric Department, Hospital / Q000592:standards*; D012559:Schizophrenia / Q000628:therapy*