Feasibility study of implementing an adapted psychosis pathway based on principles of stroke pathway

Study ID: 19187
Short Title: TRIumPH/ Treatment and Recovery in Psychosis
Organisation: Dorset Healthcare University NHS Foundation Trust
Location: Dorset Healthcare University NHS Foundation Trust
Condition: Psychosis
Main Specialty: Mental Health
Expected End Date: 31/10/2018
Postcode: BH1 4JQ
Contact Name: DHUFT Research & Development
Contact Email: dhc.research&development@nhs.net
Active: Yes

Inclusion Criteria

Routinely collected data sample group: Every patient that is accepted by the MH teams in Southern Health NHS Foundation trust from 01/04/2015 Surveys & Focus Groups: Inclusion criteria:

1. All first episode psychosis mental health service users and carers who are accepted by the services in Southern Health NHS foundation trust (SHFT) and are 18 years or older.

2. Able to give informed consent.

3. Able to speak and understand English.

4. All staff who are involved in providing care for patients with psychosis.

Exclusion Criteria

Surveys/focus groups: Any participant who does not have the mental capacity to consent to participate when the survey is conducted.

Study summary:

Development and implementation of the Stroke pathway is one of the innovations that has transformed outcomes for patients with Stroke. There are similarities in the service management and implementation of evidence-based practice for psychosis with Stroke, despite the apparent differences.

We propose an adaptation and implementation of a psychosis pathway based on the stroke pathway template using:

Staged and branched approach
• Over time and course of illness (e.g. time frames for access to services, interventions, expectations for access to therapies)
• For different levels of severity and presentations of the illness – early presentation/acute crisis/ chronic presentation
• For different presentations like comorbidities, e.g. drug and alcohol misuse, trauma responses, delusional disorder

The intention is that the pathway will provide evidence-based approaches based on NICE Clinical Guidelines for Schizophrenia and Psychosis (2014) including good practice in service delivery.

We will incorporate outcome and quality measures to measure impact on patient outcomes and experience.

The psychosis pathway will address the unmet health need of patients with psychosis. The benefits of testing this intervention will result in improved patient outcomes, economic gains through greater health care delivery efficiency, and a systematic manner in which to generalize the programme for broad use. Ultimately, the psychosis pathway will lead to:

a. Improved early detection and potential recovery for patients
b. Early uptake of evidence-based treatments (based on NICE guidelines)
c. Appropriate admission rates, lengths of stay and compulsory admissions
d. Outcome measurement and quality standards guiding service delivery and clinical research
e. Improved physical health reflected in appropriate monitoring

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