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Improving Quality of Care Among Patients Hospitalized with Schizophrenia: a Nationwide Initiative

Published online by Cambridge University Press:  15 April 2020

M. Jϕrgensen
Affiliation:
Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aalborg, Denmark
J. Mainz
Affiliation:
Department South, Aalborg Psychiatric Hospital, Aalborg, Denmark
M.L. Svendsen
Affiliation:
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark
M. Nordentoft
Affiliation:
Psychiatric Centre Copenhagen, University of Copenhagen Faculty of Health Sciences, Copenhagen, Denmark
I. Voldsgaard
Affiliation:
Aarhus University Hospital, Psychosis Ward Section P, Risskov, Denmark
L. Baandrup
Affiliation:
University of Copenhagen, Center for Neuropsychiatric Schizophrenia Research Mental Health Center Glostrup, Copenhagen, Denmark
P. Bartels
Affiliation:
Danish Clinical Registries, Danish Clinical Registries, Aarhus N, Denmark
S. Paaske Johnsen
Affiliation:
Aarhus University Hospital, Department of Clinical Epidemiology, Aarhus N, Denmark

Abstract

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Introduction

The effectiveness of systematic quality improvement initiatives in psychiatric care remains unclear.

Objectives

To elucidate the adherence to recommended evidence-based guidelines in clinical practice.

Aims

To examine whether the quality of care among patients hospitalized with schizophrenia has changed following the implementation of a systematic monitoring and auditing program of hospital performance measures.

Methods

In a nationwide population-based cohort study, we identified 14,228 patients admitted to Danish psychiatric departments between 2004 and 2011 and registered in The Danish Schizophrenia Registry. The registry systematically monitors and audits the adherence to clinical guideline recommended processes of care at all Danish psychiatric hospital departments treating patients with schizophrenia.

Results

The overall proportion of all relevant recommended processes of care delivered to the patients increased from 64 % to 76 % between 2004 and 2011. The adherence to a number of individual processes of care increased over time, including assessment of psychopathology using a diagnostic interview (Relative risk (RR) 2.01, 95 % CI: 1.50; 2.69), contact with relatives (RR 1.44, 95 % CI: 1.27; 1.62), psychoeducation (RR 1.33, 95 % CI: 1.18; 1.48), psychiatric aftercare (RR 1.06 95 % CI: 1.01; 1.11) and suicide risk assessment (RR 1.31, 95 % CI: 1.20; 1.43). However, improvements were not observed for all assessed processes of care and substantial variation remained between the hospitals.

Conclusions

Quality of care improved substantially from 2004 to 2011 among patients hospitalized with schizophrenia at Danish hospitals. However, continued efforts to reduce performance variation between hospitals are warranted.

Type
Article: 0236
Copyright
Copyright © European Psychiatric Association 2015
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