Exploring EBP Quality Improvement Substance Use Disorder

Module 3 Assignment: Exploring EBP Quality Improvement

There are various kinds of healthcare settings that mental health patients can chose for treatment depending on their financial ability and severity of their mental illness. The first healthcare setting that I would explore in my project is a psychiatric hospital. I work in the said setting. The other two healthcare settings that I would explore in my EBP quality improvement project will be in a private practice and an assisted living health facility or a residential health facility. A psychiatric hospital is an in-patient facility that happens to be a good option for patients in need of both long and short-term services. Essentially, the mission of a psychiatric hospital is to provide care for patients with severe mental health illnesses (Dye, n. d). The structures in a psychiatric hospital happen to be similar as those of a regular hospital. In addition to treatment and diagnostic areas and roles, a psychiatric hospital also has functions associated with administration, housekeeping, supply, and dietetics. Some sites also serve as training grounds for professionals in mental health and as sites for research.

A private practice happens to be a primary form of mental health facility. In this type of setting, a mental health professional utilizes an office-like structure to render services related to mental health (Dye, n. d). A private practice may consist of a single business center with various offices where different mental health professionals operate. Therefore, it would be prudent to note that a private practice is owned by private practitioners such as psychologists, counselors, and therapists who have their own offices. The said offices can be positioned in various locations which are inclusive of, but they are not limited to; medical plazas, office parks, and homes. The mission of a private practice could be to avail the relevant assistance to mental health patients (Dye, n. d). In some instances, some facilities could receive some form of funding from the state or gain access to grants. To a large extent, patients in private practice are charged depending on their ability to pay. However, most private practices do not provide in-patient services.

The third healthcare setting in mental health happens to be an assisted living facility. The said facilities are also referred to as a residential facility. A residential health facility is a private or a semi-private facility which happens to be a single institution. The said facilities can be very expensive and in some instances, decisions to liquidate the assets of residents are made so as to cater for bills in the said institution. The mission of an assisted living facility is to provide various services to people who cannot care for themselves owing to their permanent mental health conditions (Dye, n. d). In addition, the author further suggests that persons are taken to such facilities owing to the fact that they lack families who have the ability to care for them. It is important to note that residents in an assisted living facility are permitted to live normal lives whereby those who are capable are allowed to work in some way or another. In addition, the said residents are allowed to have visitors or even visit others outside the said resident with minimal restriction (Dye, n. d). Services provided in residential facilities are inclusive of, but they are not limited to; activities, meals, and housekeeping. These are of great relevance to residents with inhibiting problems.

The three settings explained above have various strengths and weaknesses. To start with, it would be prudent to note that the said settings are important in mental health owing to the fact that they provide crucial diagnostic and treatment services to mentally ill patients. For instance in a psychiatric hospital, patients with severe mental illnesses are treated in in-patient wards. The said patients are placed in in-patient wards owing to the fact that they can be threats to themselves and others (Dye, n. d). For this reason, it is important to note that psychiatric hospitals are important to both those presenting with various mental health conditions, as well as to the larger community. On the other hand, a residential health facility provides treatment to patients with permanent mental health conditions (or other related disabilities) that affect their ability to take care of themselves – especially in those scenarios whereby such patients do not have families who would take care of them. The main drawback of the said healthcare facilities happens to the costs involved. For instance, some residential health facility costs could be prohibitive. This could be a major drawback in efforts to secure the health and wellbeing of patients who are economically disadvantaged. Many patients may not have access to meaningful medical insurance cover to cater for the said costs. Moreover, some residents may not have any investments or pensions to pay the facility. To a large extent, private practices are owned by healthcare professionals and patients are usually charged depending on their ability to pay for the diverse services (Dye, n. d).

There are various problems that patients present with in the settings highlighted above. For instance in a psychiatric hospital, the practice problem that I explored was substance use disorder. According to Mayo Clinic (2017), substance abuse disorder relates to an individual’s uncontrolled or unhinged utilization of psychoactive drugs. The type of drug determines how fast one would be addicted or the risk of the said addiction. Some of the symptoms of substance use disorder are inclusive of, but they are not limited to; engagement in risky activities, cutting back on social recreational activities or not meeting work responsibilities, spending too much money on drugs, having intense urges for the drug of choice, etc. (Mayo Clinic, 2017). Substance use disorder presents different signs and symptoms depending on the type of drug. For instance, individuals using cannabis, hashish, and marijuana may present with exaggerated cravings for various foods, anxiety, slowed reaction time, difficulty concentrating, decreased coordination, dry mouth, red eyes, and a sense of euphoria (Mayo Clinic, 2017). It is important to note that individuals with addiction problems do not always seek help. For this reason, there is need for health care providers to collaborate with friends and families of the person who is struggling with such addictions.

The practice problem that I explored in a private practice happens to be depression. According to Unutza and Park (2012), depressive disorder happens to be one of the most common mental health problems in primary care. Persons with depression may present with various symptoms which are inclusive of, but they are not limited to; loss of interest in previously pleasurable engagements, feeling of extreme sadness, poor general health outcomes, fatigue, etc. (Unutza and Park, 2012). The main needs in a private practice setting happens to be a population-based and systematic approach that involves the application of evidence-based interventions. Providers collaborate with other professionals to further promote positive outcomes.

In a residential health facility, one of the practice problem that happens to be rather commonplace is dementia. According to Mayo Clinic (2021), dementia is a group several diseases that affect an individual’s social and thinking ability. In older people, dementia is often caused by alzheimer’s disease. Apart from the said disease, dementia is also caused by loss or damage of nerve cells. Some of the most common risk factors of dementia that cannot be reversed are Down syndrome, family history, and age. Risk factors such as head trauma, air pollution, smoking, diabetes, depression, and cardiovascular diseases can be adapted. The most common signs and symptoms of dementia are inclusive of, but they are not limited to; hallucinations, anxiety, depression, personality changes, confusion and disorientation, memory loss, and difficulty reasoning or handling complex tasks (Mayo Clinic, 2021). Management of dementia requires the deployment of various strategies.

Treatment of substance use disorders requires the use of pharmacotherapy treatments which calls for the deployment of evidence-based practices. It is important to note that depression decreases the quality of life of the affected persons as well as their families. This is more so the case given that the said disorder is associated with poor health outcomes, decreased work productivity, and premature mortality. For this reason, managing the said condition effectively by use of evidence-based treatments such as psychotherapy and medications would help improve the quality of life of patients. On the other hand, it should be noted that improving the quality of life happens to be the main goal of treatment in the case of dementia. This is more so the case given that dementia affects the quality of life of the affected individual in multiple formats. Therefore, evidence-based psychosocial interventions are important on this front and may involve increasing self-efficacy, decreasing burden, and improving the effectiveness of caregivers in residential health facilities (Logsdon, McCurry and Teri, 2007).

Quality improvement is an important process in healthcare that requires active participation of various stakeholders. The said stakeholders tend to have different needs. For instance, in a psychiatric hospital, stakeholders include sectors involved in mental healthcare, governmental and non-governmental organizations, universities, service managers, family groups, people with mental health disorders, and mental health workers (World Health Organization, 2003). The main stakeholders in private practice facilities are inclusive of, but they are not limited to; family members, people with mental health disorders, mental health workers, planners, funders, and policy-makers. In residential health facilities, family members, policy-makers, organizations of people with mental health disorders, human rights organizations, and advocacy organizations are the main stakeholders. Individuals with mental health disorders are in need of access to high quality and affordable care which will be responsive to their needs. Family members also require quality care that is responsive to the needs of their loved ones presenting with various mental health concerns. Mental health workers come in handy in efforts to ensure that there is continuity and stability in care. Therefore, it is important to note that the said workers require training so as to gain the skills required to advance these interests. Academic institutions such as universities are instrumental in quality improvement through evaluation, research, training, and education (World Health Organization, 2003). Mental health organizations also require resources to be able to provide effective care to patients. Policy-makers are also important in health care given that they provide direction and leadership which ensures that satisfactory quality is provided at various levels.

It would be prudent to note that in the three healthcare settings highlighted in this context, the opinion and input of various stakeholders is critical. For instance, the input of patients presenting with various mental health disorders as well as that of their family members is crucial in quality improvement efforts. This is also the stakeholder group that gains most following improvements in quality of care. Mental health workers are important stakeholders in all settings – effectively meaning that their viewpoints are equally crucial.

My main focus in a hypothetical presentation to stakeholders would be based on a psychiatric hospital. I would in this case focus on substance use disorder as the proposed practice problem. I chose the said site owing to the fact that I work in a similar setting and happen to be familiar with diverse aspects of the same. Substance use disorders affect many individuals, both teenagers and adults. Failure to deploy the relevant interventions could have detrimental effects on the wellbeing of those directly affected as well as their families and the larger community. Treatment of the said disorders requires utilization of evidence-based practices to ensure that the treatment interventions are effective. The framework model that I would use for the evidence-based quality improvement project would be based on the theory of reasoned action. As per the said theory, human behavior is said to be under voluntary action which is predicted by their intention to perform the said behavior (Fishbein and Ajzen, 2010). The said intention can be influenced by a person’s attitude or by other people who are important to the said person. Essentially, a person will engage in a certain behavior if they have a positive attitude towards the said behavior. On the other hand, a person will engage in the said behavior if important people in their life approves of the said behavior.