2 Inhoud Inleiding Core-fidelity scale en shortlist Eerste experiment met lijst binnen platformDiscussiewelke items zijn belangrijk om IHT te definiëren enwelke items onderscheiden t.o.v. reguliere crisisdiensten en andere outreachende teams.
3 InleidingIHT = een multidisciplinair behandelteam dat intensieve behandeling thuis biedt aan mensen met acute spoedeisende psychiatrische problemen. Dit met als doel opnames te voorkomen en te verkorten.Er is behoefte aan een definitie/criteriaIn Groot-Brittannië is een modelgetrouwheidsschaal ontwikkeld.Er is nog geen Nederlands modelgetrouwheidsschaal
4 Onderzoek in Engeland Slechts 40% vindt zichzelf CRHT Slechts een derde poortwachterSlechts 50% 24 x 7 beschikbaarIn onderzoek zeer wisselende resultatenLastig te koppelen aan modelgetrouwheid omdat dit niet beschreven isWheeler, C. e.a. (20015) Implementation of the CRT model in adult mental health settings: a systematic review. BMC Psychiatry 15:74
5 Discussie Noodzaak modelgetrouwheidsschaal Vorm Certificering als bij FACTAnder vormItems fidelity-scale, werkbaar?
6 Core-fidelity scale core Crisis Resolution Team Fidelity Scale Versie 1 juli 2013Versie 239 itemsScoringcriteria veranderdShortlist 13 itemsDeveloped by Brynmor Lloyd-Evans, Sonia Johnson and the CORE Research Group*
7 Core- fidelity 1. The CRT responds quickly to new referrals 2. The CRT is easily accessible to all eligible referrers3. The CRT accepts referrals from all sources4. The CRT will consider working with anyone who would otherwise be admitted to adult acute psychiatric hospital5. The CRT provides a 24 hour, seven day a week service6. The CRT has a fully implemented “gatekeeping” role, assessing all patients before admission to acute psychiatric wards and deciding whether they are suitable for home treatment
8 Core- fidelity 7. The CRT facilitates early discharge from hospital 8. The CRT provides explanation and direction to other services for service users, carers and referrers regarding referrals which are not accepted9. The CRT responds to requests for help from service users and carers whom the CRT is currently supporting10. The CRT is a distinct service which only provides crisis assessment and brief home treatment11. The CRT assertively engages and comprehensively assesses all service users accepted for CRT support
9 Core- fidelity12. The CRT provides clear information to service users and families about treatment plans and visits13. The CRT closely involves and works with families and wider social networks in supporting service users14. The CRT assesses carers’ needs and offers carers emotional and practical support15. The CRT reviews, prescribes and delivers medication for all service users when needed16. The CRT promotes service users’ and carers’ understanding of illness and medication and addresses concerns about medication
10 Core- fidelity 17. The CRT provides psychological interventions 18. The CRT considers and addresses service users’ physical health needs19. The CRT helps service users with social and practical problems20. The CRT provides individualised care21. CRT staff visits are long enough to discuss service users’ and families’ concerns22. The CRT prioritises good therapeutic relationships between staff and service users and carers23. The CRT offers service users choice regarding location, timing and types of support
11 Core- fidelity 25. The CRT plans aftercare with all service users 24. The CRT helps plan service users’ and service responses to future crises25. The CRT plans aftercare with all service users26. The CRT prioritises acceptability to service users in how CRT care is ended27. The CRT has adequate staffing levels28. The CRT has a psychiatrist or psychiatrists in the CRT team, with adequate staffing levels29. The CRT is a full multi-disciplinary staff team
12 Core- fidelity30. The CRT provides a thorough induction programme for new staff and ongoing training and supervision in core competencies for CRT staff31. The CRT has comprehensive risk assessment and risk management procedures, including procedures for safeguarding children and vulnerable adults living with CRT service users32. The CRT has systems to ensure the safety of CRT staff members33. The CRT has effective record keeping and communication procedures to promote teamwork and information sharing between CRT staff
13 Core- fidelity34. The CRT works effectively with other community services35. The CRT takes account of equality and diversity in all aspects of service provision36. The CRT has systems to provide consistency of staff and support to a service user during a period of CRT care37. The CRT can access a range of crisis services to help provide an alternative to hospital admission for service users experiencing mental health crisis38. The CRT provides frequent visits to service users39. The CRT mostly assesses and supports service users in their home
14 Core- fidelity 25. The CRT plans aftercare with all service users 24. The CRT helps plan service users’ and service responses to future crises25. The CRT plans aftercare with all service users26. The CRT prioritises acceptability to service users in how CRT care is ended27. The CRT has adequate staffing levels28. The CRT has a psychiatrist or psychiatrists in the CRT team, with adequate staffing levels29. The CRT is a full multi-disciplinary staff team
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