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Implementing and evaluating a Virtual Mental Health Day Hospital

The project focuses on evaluating the clinical outcomes of a Virtual Mental Health Day Hospital piloted in a leading Independent Mental Health Service in Ireland to inform redesign and improvement.

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  • Proposal
  • 2022

Meet the team

Also:

  • Timothy Frawley, Associate Professor in Mental Health Nursing, University College Dublin, Ireland
  • Geraldine Corr, Director of Nursing, St. John of God Hospital, Stillorgan, Co. Dublin, Ireland

What is the challenge your project is going to address and how does it connect to the theme?

Providing enhanced access to mental health services is a key policy imperative, with ‘Sharing the Vision’ noting that this can be met through digital delivery (Government of Ireland, 2020; Taylor et al. 2020). In fact, a recently published scoping review (Safieh et al. 2021) found that digital health interventions have high potential user acceptability internationally. Building on this work, it is important to determine the adaptability of a digital health model within Irish mental health services.

Athrú (Irish for ‘Change’) is an online platform that patients will be able to use to access all the resources they need including their timetable, links to their group sessions and any materials they need for attending their group. The platform is in place and has been piloted with the first group of participants – we now plan to evaluate the pilot with participant patients and staff to further inform its design and application.

What does your project aim to achieve?

McCormack (2017) notes that healthcare can often rely exclusively on measurement (metrics), hard evidence, and tangible outcomes, which are not necessarily facilitators of person-centredness. McCormack and colleagues (2010)  state that healthcare delivery needs to move towards a culture that contextualises and integrates the ‘hard’ evaluation of outcomes and programmes within an overarching person-oriented evaluation framework.

We propose to build on our previous experience of person-centred evaluation (Teeling, Dewing & Baldie, 2020,2021, 2022) that support the enhancement of person-centred cultures, to evaluate both patient and staff experiences of the initial pilot of ‘Athrú’.  This will inform the improvement and co-redesign of the Athrú platform, ensuring improvement in platform design is measured not only in the volume of patients using the platform but by capturing an authentic voice of the customer to further inform platform development. This will ensure that the improvement fully considers the complexity of social interactions and dynamics in healthcare settings (Goodridge et al, 2015).

How will the project be delivered?

We will evaluate the initial pilot of Athrú using person-centred data collection methods involving a direct participant interface including:

  • a series of facilitated workshops with patient participants to gather participants’ views and experiences of using Athrú
  • a series of facilitated workshops with staff participants to gather participants’ views and experiences of using Athrú  in their practice areas
  • Semi-structured interviews with both patient and staff participants
  • Dissemination of evaluation data to other patients and staff who have not participated in the pilot, sharing with them the evaluation data to enable them to offer their voice and further inform the platform design.
  • The data will directly inform a co-redesigned Athrú  evolution

We will use person-centred creative methods at each stage (Teeling, Dewing & Baldie, 2021, 2022) to create time and space for participants to reflect on issues that arise and allow time for reflection within the working themes of connectedness, hope, resilience, empowerment and meaning.

How is your project going to share learning?

Dissemination and knowledge exchange will be guided by the Agency for Healthcare Research and Quality (AHRQ) Dissemination Planning Tool which helps researchers evaluate their research and develop appropriate dissemination plans that will have a “real world” impact (Carpenter et al., 2014). Components of the Tool are: (1) specifying research findings and products; (2) identifying end-users; (3) working with dissemination partners; (4) communicating the message; (5) evaluating success; and (6) dissemination work plan.

The dissemination impact will be ensured by involving knowledge users, PPI and learner involvement through our co-applicants and collaborators for the project. Publication outputs will be actualised quickly using online platforms such as Health Research Board Open Access and similar reputable journals and repositories internationally. There is also an opportunity to relay research outputs to the wider community through traditional media such as radio, workshops, symposia as well as through social media platforms.

How you can contribute

  • We would welcome feedback from person-centred practitioners as to their approaches to improvement.
  • We would welcome feedback from colleagues in mental health in the wider Q community as to the enablers and mechanisms that have led to positive outcomes for patients using online virtual platforms and clinics.
  • We would appreciate the wider Q Community’s help in hearing stories of innovation and practice changes in mental health.
  • Thank you for your valuable input.

Plan timeline

4 Sep 2022 Team values and visions workshop
18 Sep 2022 Co-led team planning workshop - PDCA & person-centred framework
25 Sep 2022 Participant invitations and pack
9 Oct 2022 Follow up with & consolidation of participants
16 Oct 2022 Patient workshops
30 Oct 2022 Staff workshops
13 Nov 2022 Data collation and analysis
8 Jan 2023 Semi-structured interviews Patients
29 Jan 2023 Semi-structured interviews Staff
31 Mar 2023 Data collation and analysis
30 Apr 2023 Sharing evaluation data with wider patients & staff outside pilot group
14 May 2023 Collation of feedback data from patients & staff outside pilot group
28 May 2023 Data informs redesign & enhancement of Athrú platform - field test - PDCA
25 Jun 2023 Redesign Workshop with development team - field test - PDCA
7 Aug 2023 Following field testing, full launch of redesigned platform - PDCA
13 Aug 2023 Iterative dissemination of findings throughout project duration (see shared learning)

Comments

  1. Thank you for a great improvement idea and evaluation plan co created by an integrated service, education and research team. The video clip gives a great sense of  Athru digitally enabled service.   It super to see the proposed use of person-centered creative methods being integral to the evaluation process.

    1. Thank you for your comments, Maureen, much appreciated.  We plan to use a person-centred framework throughout.  Lá Fhéile Pádraig sona duit!

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