RROHC in Psychiatry

As a result of the RROHC program, I am working on establishing Patient Centered Care on my inpatient psychiatric unit. Do you know of any hospitals in the Northeast or even nationwide that have successfully incorporated Patient Centered Care on their psych units?
Thank you.
Leslie Gosselin
Norwalk Hospital

3 Responses to “RROHC in Psychiatry”

  1. Ruth Says:

    I’d be delighted to share our experiences. We have instituted several PFCC practices on our inpatient psych units already. RROHC is a natural fit with our desire to continuously strive for opportunities to fully integrate patient/family choice and voice in care.

    Darcy Jaffe, ARNP
    Assistant Administrator
    Ambulatory & Allied Care Services
    Harborview Medical Center
    325 9th Ave Box 359935
    Seattle, WA 98104

    Phone 206 744 6630
    Fax 206 744 8688
    Pager 206 994 3325

  2. Ruth Says:

    Sounds like you are doing a great job! and yes, ANY Changes on a care plan or map is great..shows that partnering and individualization.
    Now, re: to the checkpoints. here is what I would suggest. Do a bit of coaching for the checkpoints: i.e.:here are a few questions to ask staff working together, as you draw them together for a moment:
    1) for the first checkpoint after 1 to 1s or AM patient eval: What’s changed in POC? How are things going?
    2) before and after breaks and meals: Updating work completed and changes in condition or update from interdisciplinary team
    3) Last checkpoint: “What would you do differently if you had this same assignment tomorrow? What would you recommend the MH tech would do differently? What would you commend each member of your team for their particular expertise?” these kinds of questions.
    That last checkpoint is GOLDEN. people begin to Like doing it and then it becomes part of their day, b/c they are encouraged to not only give feedback that needs to be said earlier rather than later “gee I wish the RN would have told me about that med change so I could have watched for ____” BUT they get to celebrate! “Mr. Jones has had fewer auditory halllucinations”! especially with the incremental tiny changes in psych patients! it’s nice to notice and celebrate the impacts we make.
    Hope that helps you!
    let us know how it goes!
    Thanks Ruth

  3. Ruth Says:

    Leslie, I certainly think mental health unit needs are just naturally attended to by implementation of RROHC principles…they fit well. We already were doing many of those things, but we have improved and streamlined them and hey work better! The SHIFT REPORT (capitalized because it’s so important) is in constant metamorphosis. One minute per patient isn’t too far off…we have max of 8 pts. We print our documentation…whole team…and place it in report book with daily Kard-x plus the picture of the pt. (ALOS=7 days). Each nurse’s documentation includes the 4 Ps, but we chart with an APIE note: Assessment, Plan, Interventions, and Evaluation. Charge nurse reads the report highlights to oncoming shift, questions and answers asked and given.! (any suggestions?) Our multi-disciplinary Treatment Plan has undergone a complete “overhaul” this past year in our determination to make the care truly “patient-centered” and to make the plan belong to the patient. It has become a “caremap” and a tool that is used every time the nurse meets with the patient. Everybody writes in it, including the patient. The plan is out on the table every day for Case Review…and, believe it or not, notes are made on it…and, sometimes…CHANGES MADE! That’s a little tongue-in-cheek because we used to NEVER change the plan with the patient’s changes. Since we have mobile patients who frequently have faulty perceptions and memories, we put all our pictures on the wall beside the assignment board, along with our role. This has really helped introductions. One thing we have NOT done is “checkpoints”…the staff works so closely together that we haven’t found a way to do that effectively. And we know that working that closely does NOT guarantee good communication. Any thoughts about how to do that in an area where we’re often “on top” of each other? Looking forward to hearing from you…questions welcome..and any hints that you might have. Bonnie Klages RN C Manager, Mental Health Unit Marion General Hospital

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