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

NCT06250296 | Recruiting

• 1 other identifier: RP-07-06
• Study Type: observational
• Target: 700
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Psychiatric Hospitalization; Coercion; Recovery

Keywords

psychiatric inpatient care; coercion; recovery; patient satisfaction

Outcome Measures

Primary Outcomes (1)

• Coercive measures

  Number, type and duration of used coercive measures (seclusion or forced medication)

  For each included participant at discharge from hospital, throughout the study (18 months)

Secondary Outcomes (9)

• Length of stay

  For each included participant at discharge from hospital, throughout the study (18 months)

• Symptom burden

  For each included participant at discharge from hospital, throughout the study (18 months)

• Length of stay under involuntary status

  For each included participant at discharge from hospital, throughout the study (18 months)

• Personal recovery

  For each included participant at discharge from hospital, throughout the study (18 months)

• Subjective coercion 1

  For each included participant at discharge from hospital, throughout the study (18 months)

Study Arms (2)

Intervention group

All patients admitted to the ward implementing the foreseen intervention as to February 2024 (pilot phase)

Other: New model of psychiatric inpatient care

Control group

All patients admitted to the two wards implementing the foreseen intervention after the initial pilot phase

Interventions

New model of psychiatric inpatient care OTHER

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.

Intervention group

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study 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.

You may qualify if:

• Patients hospitalized in one of the three participating wards

You may not qualify if:

• Incapacity to give informed consent
• Insufficient knowledge of French

Sponsors & Collaborators

• University Hospital, Geneva: lead
• Fondation Privée des HUG: collaborator
• IF International Foundation: collaborator

Study Sites (1)

HUG - Hôpital de Belle-Idée

Thônex, 1226, Switzerland

RECRUITING

MeSH Terms

Conditions

Patient Satisfaction

Condition Hierarchy (Ancestors)

Treatment Adherence and Compliance; Health Behavior; Behavior

Study Officials

• Alexandre Wullschleger, MD

  University Hospital, Geneva

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Alexandre Wullschleger, MD

CONTACT

+41795534904; alexandre.wullschleger@hcuge.ch

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator

Study Record Dates

• First Submitted: January 29, 2024
• First Posted: February 9, 2024
• Study Start: February 15, 2024
• Primary Completion: October 1, 2025
• Study Completion: October 1, 2025
• Last Updated: July 3, 2024

Record last verified: 2024-07

Locations

CH (1)