Online Program

Development of combined assessment of psychiatric environments (CAPE) profiles: A patient-centered quality measure for inpatient psychiatric treatment

Tuesday, November 5, 2013 : 8:30 a.m. - 8:50 a.m.

Kathleen Delaney, PhD, PMH-NP, FAAN, Department of Community, Mental Health and Systems, Rush College of Nursing, Chicago, IL
Individuals who require psychiatric hospitalization need a safe environment that supports stabilization and service planning that promotes a meaningful life in the community. Both processes require a recovery-oriented, patient-centered treatment environment where care reflects the patient's needs, values, and choices. It also requires a nursing staff that builds a unit culture which instills hope, self-direction, and empowerment. Currently there is no method to assess the delivery of recovery oriented, patient-centered care in the psychiatric inpatient environment. The focus of this study was development of an instrument (Combined Assessment of Psychiatric Environments- the CAPE) that assesses quality of care by gauging the extent patients have experiences during inpatient treatment that promote recovery and patient-centered care; i.e., ones marked by safety, engagement, respect, choice, achievement, and significance. A staff-form of the tool gauges the extent the environment supports nurses ability to provide an empowering, patient-centered environment of care. This presentation will report on the conceptual framework of the instrument, how items were derived from staff interviews and patient focus groups and then further refined by consumer/staff frequency ratings of the initial item pool. In the second phase of the study the instrument was tested on six inpatient psychiatric units. The resultant data and psychometrics of the instrument will be presented. Included is a discussion of how the instrument facilitates quality assessment and patient-centered care of inpatient psychiatric environments. The instrument also has the potential to detect outcomes of a staff group's efforts at recovery-oriented culture change.

Learning Areas:

Public health or related research

Learning Objectives:
Describe how qualitative methods can be used to construct items for patient-centered quality tool. Explain elements of patient-centered care that contribute to quality of inpatient psychiatric treatment. Describe how inpatient psychiatric staff might use a newly developed tool to capture their efforts at patient-centered care.

Keyword(s): Health Care, Public Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal of several investigations, a federally funded grant and now a PCORI grant focusing on safety and quality of inpatient psychiatric treatment. I have published widely on issues of safety and restraint reduction and recovery in inpatient psychiatric treatment and I am currently co-chair of the American Psychiatric Nurses Association, Institute for Safe Environments.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.