title: [Influence of an "Open Door Policy" on Ward Climate: Impact on Treatment Quality].
abstract: To compare the ward atmosphere, safety, therapeutic hold, and patients' coherence on recently opened (1 year), opened (4 years) and open (> 20 years) psychiatric wards in a longitudinal naturalistic study design. The question was if a patient shift from formerly locked to open wards might deteriorate the ward atmosphere on the open and opened wards.
  
  
  
  Ward atmosphere on two recently opened (n = 2), opened (n = 2) and open (n = 2) wards was examined using the Essen Climate Evaluation Schema (EssenCES) in a follow-up study after 4 years. Structural as well as clinical data were extracted.
  
  
  
  Global ward atmosphere, safety, and patients' coherence on the recently opened wards was significantly increased; on always opened wards and long-term opened wards it remained unchanged. Coercive measures and discharges against medical advice decreased during the open door process.
  
  
  
  Opening locked psychiatric wards can help to establish a positive therapeutic atmosphere without changing the therapeutic climate on the other already open wards. A better ward atmosphere might be connected with a better therapeutic quality.
authors.affiliation: Universitäre Psychiatrische Kliniken (UPK) und Universität Basel, Schweiz.
authors.forename: Sou Bouy
authors.initials: SB
authors.lastname: Lo
authors.affiliation: Universitäre Psychiatrische Kliniken (UPK) und Universität Basel, Schweiz.
authors.forename: Rainer
authors.initials: R
authors.lastname: Gaupp
authors.affiliation: Universitäre Psychiatrische Kliniken (UPK) und Universität Basel, Schweiz.
authors.forename: Christian
authors.initials: C
authors.lastname: Huber
authors.affiliation: Universitäre Psychiatrische Kliniken (UPK) und Universität Basel, Schweiz.
authors.forename: Andres
authors.initials: A
authors.lastname: Schneeberger
authors.affiliation: Universitäre Psychiatrische Kliniken (UPK) und Universität Basel, Schweiz.
authors.forename: Gabrijela
authors.initials: G
authors.lastname: Garic
authors.affiliation: Universitäre Psychiatrische Kliniken (UPK) und Universität Basel, Schweiz.
authors.forename: Alexander
authors.initials: A
authors.lastname: Voulgaris
authors.affiliation: Universitäre Psychiatrische Kliniken (UPK) und Universität Basel, Schweiz.
authors.forename: Marc
authors.initials: M
authors.lastname: Walter
authors.affiliation: Universitäre Psychiatrische Kliniken (UPK) und Universität Basel, Schweiz.
authors.forename: Stefan
authors.initials: S
authors.lastname: Borgwardt
authors.affiliation: Universitäre Psychiatrische Kliniken (UPK) und Universität Basel, Schweiz.
authors.forename: Undine E
authors.initials: UE
authors.lastname: Lang
mesh_terms: D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D001523:Mental Disorders; D011567:Psychiatric Department, Hospital; D011787:Quality of Health Care; D012931:Social Environment