Factors influencing the admission decision for Medical Psychiatry Units: A concept mapping approach.

Autor: Caarls PJ; Erasmus Medical Center, University Medical Center, Rotterdam, The Netherlands., van Schijndel MA; Erasmus Medical Center, University Medical Center, Rotterdam, The Netherlands.; Rijnstate Hospital, Arnhem, The Netherlands., Berk GVD; Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands., Boenink AD; Amsterdam University Medical Center, Amsterdam, The Netherlands., Boerman D; Rijnstate Hospital, Arnhem, The Netherlands., Lijmer JG; Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands., Honig A; Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.; Amsterdam University Medical Center, Amsterdam, The Netherlands., Terra M; Amsterdam University Medical Center, Amsterdam, The Netherlands., Thijs A; Amsterdam University Medical Center, Amsterdam, The Netherlands., Verwey B; Rijnstate Hospital, Arnhem, The Netherlands., Waarde JAV; Rijnstate Hospital, Arnhem, The Netherlands., Wijngaarden JV; Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands., Busschbach JJV; Erasmus Medical Center, University Medical Center, Rotterdam, The Netherlands.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2019 Sep 17; Vol. 14 (9), pp. e0221807. Date of Electronic Publication: 2019 Sep 17 (Print Publication: 2019).
DOI: 10.1371/journal.pone.0221807
Abstrakt: Objective: Medical Psychiatry Units (MPUs), also known as Complexity Intervention Units (CIUs), provide care for complex patients suffering from both psychiatric and physical disorders. Because there is no consensus on the indications for admission to an MPU, daily practice and effectiveness research are hampered. This study therefore used a concept mapping approach to investigate which organizational and medical factors determine the decision to admit a patient to an MPU.
Methods: The first step of the concept mapping approach was to create a list of factors determining MPU admission from literature. Secondly, clinical experts sorted and ranked these factors. The sorted and ranked data were then analyzed, and a draft conceptual framework was created. A final conceptual MPU admission framework was then drawn during an expert consensus meeting and recommendations for implementation were suggested.
Results: Thirteen clinical experts defined 90 factors from literature, which were sorted and ranked by 40 experts from 21 Dutch hospitals. This concept mapping approach resulted in a five-cluster solution for an MPU admission framework based on: 1. Staff competencies and organizational pre-requisites; 2. Patient context; 3. Patient characteristics; 4. Medical needs and capabilities; and 5. Psychiatric symptoms and behavioral problems. Furthermore, three inclusion and two exclusion criteria were formulated to help the clinicians decide whether or not to admit patients to an MPU. These criteria can be implemented in daily practice.
Conclusion: Implementing the five criteria derived from this conceptual framework will help make the admission decision for complex patients with psychiatric and physical disorders to an MPU more correct, consistent, and transparent.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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