Looking through different lenses: Case study research of a UK mental health integrated care pathway
Hall, Julie E.
Hall, Julie E.
Abstract
The use of integrated care pathways (ICPs) within psychiatric settings has gathered pace internationally while attracting a mixed and inconclusive commentary. This research, funded by the U.K. Social and Economic Research Council, was designed acknowledging the lack of robust evidence about their effect on mental health care. The aim being to systematically determine how and to what effect an integrated care pathway can be used to manage mental health care. A case study research methodology has been used to study a pathway used in acute inpatient care on 6 wards in a UK mental health NHS Trust over a 3-year period. The findings shared in this paper were reached using data collected from semistructured interviews with health care professionals, focus groups with service users and carers, documentary analysis of health records, and datasets of hospital episode and performance information. Analysis of the data reveals accounts of the how the pathway has been used in day to day practice and how this varies by geography and professional group. There are critiques about integrated working and individualized care, and the impact of the pathway on these. The accounts given by service users and carers tell of contrasting perspectives about involvement and choice, and the content of their care while on the care pathway. Additional dimensions are added by quantitative data revealing the extent to which the care pathway was implemented across the 6 wards, and datasets of hospital episode and performance information consider the impact upon the achievement of 7 day follow-up and readmission rates. The application of complexity theory as an explanatory framework, suggests that mental health ICPs need to reflect the relationships between stakeholders, variability of illness, and individual ways of living if they are to provide a framework for managing care in the future that accords with the needs of people using mental health services.
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Date
2010
Type
Article
Subject
Mental health services
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Citation
Hall, J. E. (2010). Looking through different lenses: Case study research of a UK mental health integrated care pathway. International Journal of Qualitative Methods, 9 (4), pp.354-355.