Improving quality of care among patients hospitalised with schizophrenia: a nationwide initiative
Mette Jørgensen,
Jan Mainz,
Marie Louise Svendsen,
Merete Nordentoft,
Inge Voldsgaard,
Lone Baandrup,
Paul Bartels,
Søren Paaske Johnsen
Affiliations
Mette Jørgensen
Aalborg University Hospital, Psychiatry, Aalborg, Denmark
Jan Mainz
Aalborg University Hospital, Psychiatry, Aalborg, Denmark
Marie Louise Svendsen
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark
Merete Nordentoft
Psychiatric Centre Copenhagen, University of Copenhagen, Faculty of Health Sciences, Copenhagen, Denmark
Inge Voldsgaard
Psychosis Ward, Section P. Aarhus University Hospital, Risskov, Denmark
Lone Baandrup
Center for Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, University of Copenhagen, Faculty of Health Sciences, Copenhagen, Denmark
Paul Bartels
Danish Clinical Registries, Aarhus N, Denmark
Søren Paaske Johnsen
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark
Background The effectiveness of systematic quality improvement initiatives in psychiatric care remains unclear. Aims To examine whether quality of care has changed following implementation of a systematic monitoring programme of hospital performance measures. Method In a nationwide population-based cohort study, we identified 14 228 patients admitted to psychiatric departments between 2004 and 2011 from The Danish Schizophrenia Registry. The registry systematically monitors the adherence to guideline recommended processes of care. Results The overall proportion of all relevant recommended processes of care increased from 64 to 76% between 2004 and 2011. The adherence to individual processes of care increased over time, including assessment of psychopathology using a diagnostic interview (relative risk (RR): 2.01, 95% CI: 1.51–2.68), contact with relatives (RR: 1.44, 95% CI: 1.27–1.62), psychoeducation (RR: 1.33, 95% CI: 1.19–1.48), psychiatric aftercare (RR: 1.06, 95% CI: 1.01–1.11) and suicide risk assessment (RR: 1.31, 95% CI: 1.21–1.42). Conclusions Quality of care improved from 2004 to 2011 among patients hospitalised with schizophrenia in Denmark.
