Exploring Factors Impacting the Implementation of Recovery-Oriented Treatment Planning on Acute Inpatient Mental Health Units

被引:0
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作者
Sarah A Shue
Morgan Traylor
Marina Kukla
Michelle P Salyers
Angela L. Rollins
Nancy Henry
Johanne Eliacin
Jennifer Garabrant
Alan B McGuire
机构
[1] Richard L. Roudebush VA Medical Center,Center for Health Information and Communication, Health Services Research & Development
[2] Indiana University-Purdue University at Indianapolis,Department of Psychology
关键词
Veterans Health Administration; Goal setting; Treatment team; Normalization process theory; Qualitative methods;
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摘要
Purpose: The current literature on operationalizing and implementing recovery-oriented inpatient care in diverse settings remains limited. The present study systematically examined factors affecting the implementation of one aspect of recovery-oriented care in a large and diverse national sample of Veterans Health Administration (VHA) inpatient mental health units. Method: VHA inpatient mental health units were scored on the Recovery-Oriented Acute Inpatient scale (RAIN). Sites scoring either one standard deviation above (n = 8; i.e., high-scoring sites) or one standard deviation below (n = 5; i.e., low-scoring sites) the mean on the RAIN factor of inpatient treatment planning subscale were included for additional analyses (N = 13). We used a qualitative approach known as emergent thematic analysis to assess the implementation of inpatient treatment planning elements (e.g., goal setting, shared decision-making) from qualitative interviews, observation notes, and chart reviews collected for the 13 sites. The analysis was guided by Normalization Process Theory. Results: The eleven themes that emerged across the elements of recovery-oriented inpatient treatment planning mostly represented commonalities across sites, such as a shared treatment philosophy of acute care. However, five themes emerged as “differentiators” that distinguished high- and low-scoring sites and included veteran input, elicitation of recovery goals, the value of group programming, and the purpose of family involvement. Conclusion: Findings provide insight into contextual factors and processes that impacted the implementation of recovery-oriented treatment planning at these VHA inpatient mental health units. To further facilitate the implementation of recovery-oriented inpatient treatment planning elements, future research should examine staff’s collective understanding of recovery-oriented inpatient care.
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页码:283 / 295
页数:12
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