Quality improvement in a psychiatric hospital

Quality improvement in a psychiatric hospital

Quality improvement in a psychiatric hospital

  • Type of paper Other
  • Subject Nursing
  • Number of pages 5
  • Writer level University
  • Format of citation APA
  • Number of cited resources 5

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Quality improvement in a psychiatric hospital


There are usually many suicide cases reported when patients are released from the hospital. Most of them occur in less than a week after discharge. Due to this reasons, there are follow-up plans that are made to ensure the patients are in good progress its aim has been implementing call-back programs to assess the patients call back follow-up care. Research has found this beneficial since more than 70% cases are prevented through this plans (Ally & Mason, 2013). This article will be focused on highlighting the most appropriate model of planned change to assess patients discharged from a psychiatric hospital.

Quality improvement

Quality improvement is a process that consists of systematic actions that are meant to lead to measurable improvements in the healthcare system.it is also aimed at improving the health status of the targeted patient groups (Robert et al, 2008). Quality services in the healthcare system are a direct correlation between the level of improvement in rendering health services and the desired outcomes in the system as applied to patients and the whole population. Quality has always been linked to the service delivery of the organization and the systems of care the organization has. One of the components that makes quality improvement a success is the focus on patients and processes of work. Follow-up is a component of the process that cannot go unnoticed. It brings a better understanding of the healthcare practices within the profession. it is key in observing the outcome of any process. It is, therefore, useful in psychiatric hospitals to make follow-up plans of the patients that are discharged. This is because it enhances patient safety, care provision that is evidence based, coordination of care with other parts of the system and support for patient engagement. It is virtually a team process. But for it to work efficiently, planned change has to be incorporated.

There’s always a tendency of the psychiatric hospitals to confine information about their patients. the patients are therefore a mystery at times to other members of the society. They tend to feel neglected as a result and might end up having poor relationships with others. This might hurt their lifestyle and health as well. The practitioners are, therefore, left with the responsibility of making follow-up plans for the patients to give them moral and psychological support. They have to seek time to do all this. To succeed, they must do a number of things that include a lot of planning.

Methods of planned change

Planned change can be achieved through various other methods. The plan, do, study, act (PDSA) model is used in quality improvement as a framework used to test the communicating strategies. It is also used to monitor the results garnered after comparative clinical indicator. The indicators are developed systematically from information gathered during PDSA. The indicators provide data for monitoring the psychiatrists’ compliance with the key aspects of the clinical practice. The PDSA model is essential since it allows the psychiatrist to assess whether a study that is imposed to change a certain process achieves its goal of bringing an improvement as desired. In analyzing the four cycles, planning is needed for the change that is to be tested. After planning, the change is then implemented hence the “do”. After the implementation, studying the change is crucial. Results gotten are analyzed and a summary of lessons learned made.  The final cycle is Act. The change strategy needs to be adjusted to fit expectations.

Planned change can be described as a nursing practice that is necessary for various reasons that include patient’s welfare as well as success in the nursing profession. at times, it might be difficult to implement the planned change mostly when it comes to a psychiatric hospital. There are different models used in planned change. Some of them include diffusion of innovation theory, Lewin’s method, Kubbler-Ross five-stage model that is commonly referred to as the change curve, Prosci’s ADKAR model and Bridge’s Transition Model.

The Lewin’s method involves change at a greater perspective. It is used almost in every kind of business today. The method uses a three-stage process that is Unfreeze-Change-Refreeze. The method was introduced by Lewin Kurt who was a social scientist. The method could as well be handy in taking care of patients in a psychiatric hospital. The methods explain organizational change using the analogy of changing events. It enables one to prepare for the oncoming events one after another. The process enhances the spirit of acceptance and acknowledgment that one will succeed. It doesn’t give room for fear of failure but cultivates the willingness to change successfully. The method requires one to re-examine the previous processes before moving on to the next. It provides one with a better platform to relate with others. The model is laid in such a way that to prepare an organization for a successful change, the values, attitudes and behaviors must be reviewed. It acknowledges that although change is inevitable, it is, in most cases, inevitable. The model, however, has some limitations. The key elements associated with unfreezing are not effective in eliminating potential risks for the participants of the change. The refreezing implies that the changes need to be cemented in the organization (Ivanov & Blue, 2008). This might cause trouble in case the organization needs to adapt newer changes.

On the other hand, the Diffusion of Innovation Theory is basically one that occurs when people adopt a new philosophy or new ideas. It was created by Roger’s in the 1960’s. It is regarded as a valuable change model for guiding communication and peer networking within the process of adoption (Child & Institute of Medicine, 2014). It is also credited with introducing the notion of opinion leaders.  This is the process that is incorporated in enhancing adoption of new ideas. The model has various benefits such as creating an understanding of the audience for the change. It helps one to understand the audience in a deeper more detailed way. The model also provides inputs that identify opinion makers and influencers (Robert et al, 2008). However, it has a number of limitations. The model does not seem to be consistent; people drift from one change adoption category to another as dictated by a specific change. Again, the model has adoption terms that are only accurate in hindsight (Ally & Mason, 2013). It does not indicate how a population might respond to the change expected.

Bridge’s Transition model can be used to understand how people feel as they are guided through the change. It makes a clear clarification about the psychological effect of the change. It, however, does not substitute for other change management approaches hence making it weak. It is difficult to use it as an independent change management model.

For Kubbler-Ross method, an individual’s reaction to change effected is well captured (Ally & Mason, 2013). It, therefore, forms a good foundation for communication strategy. The limitation of this model is that it assumes any kind of change as bad. It does not acknowledge that not all change is bad. Another shortcoming is that it cannot be used on a group of people. The major problem with it is that one cannot identify the transition between stages of change.

The most effective model is the diffusion of innovative theory. It is useful in understanding the factors impacting patient acceptance and their behavior after they are dismissed from a psychiatric hospital. This method by Rogers provides a framework that is necessary for creating and implementing plans towards change. It ensures positive adaptation for the change in an easier way than the others.


Almost all patients felt that the nurses were knowledgeable about their conditions. This provided physicians with pertinent information when writing patient reports.

The physicians surveyed felt that the model selected was effective in its follow through on the patients’ progress.

The physicians felt that the model aided in improving communication between them and their patients therefore enhancing their care and improving outcomes.

SWOT Analysis for diffusion of innovation theory

The analysis is divided into strengths, weaknesses, opportunities and threats. It assesses the situation and the model of change effected.

Strengths: Psychiatrists who have an active presence on the model influence the environment, especially if they are chosen from various shift rotations (Denice & Barker, 2016). This provides the ease of transition from one phase to another helping the whole healthcare facility to run smoothly. It creates a good understanding of the audience and provides inputs that identify opinion makers and influencers.

Weaknesses: The model does not seem to be consistent; people drift from one change adoption category to another with respect to the specific change. The model has adoption terms that are only accurate in hindsight. It does not indicate how a population might respond to the change expected.

Opportunities: The model gives rooms for expansion of the targeted group in this case the patients. it also leads to an improved and enhanced learning experience to both the psychiatrists and the patients. the system as well provides a unique specialized model of change that encourages interaction. It might also lead to an advancement of technology through its incorporation of the same.

Threats: The model exposes the psychiatrists to the fault of finding the faults. They seek to understand what is not already documented. It is, therefore not known what might happen to them. The model might as well affect other participants’ willingness to cooperate since it involves some loopholes that might lead to blame games.


Quality improvement in a psychiatric hospital could translate to good patient participation. it could improve the quality of services offered there. It has proved efficient in other areas so we would expect the same in the healthcare system. It will prove to be a reliable way of ensuring patient involvement that will as well improve patient safety.


Ally, A., & Mason, T. (2013). Seclusion and mental health: A break with the past. London: Chapman & Hall.

Child, A. P., & Institute of Medicine (U.S.). (2014). Keeping patients safe: Transforming the work environment of nurses. Washington, D.C: National Academies Press.

Denice, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession.

Ivanov, L. L., & Blue, C. L. (2008). Public health nursing: Leadership, policy, & practice. Australia: Delmar Cengage Delmar.

Robert, G., Greenhalgh, T., & Bate, P. (2008). Diffusion of Innovations in Health Service Organizations: A Systematic Literature Review. Chi Chester: John Wiley & Sons.

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