Mental Health Nursing

36. 11 point assessment
completed
By Day 49
37. Substance use
screening assessment
and initial summary
report completed
Integrated care pathways: the ‘acute’ context 129
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o LATE
o NOT DONE
o LATE
o NOT DONE
o N/A
Mental health care pathways in the UK
Health care providers in the UK are showing increasing interest in the
claimed benefits of care pathways. In 1998 the National Pathways Association
in the UK had 452 recorded pathways under research, pilot, implementation
or evaluation. Eighteen of these pathways had a mental health
focus. The current status of care pathway development is indicated by the
National Electronic Library for Health care pathway database. The database
shows a significant growth in the use of pathways in all specialisms,
with in excess of 25 mental health care organisations registering their integrated
care pathway developments.
Reviewing the literature corroborates the slow but growing use of mental
health care pathways in the UK (Jones, 1997, 1999). Care pathways
have been used for a range of mental health-related diagnoses in the US.
There are predominant accounts of the use of care pathways for patients
with schizophrenia (Anders et al., 1997; Jones and Kamath, 1998). Published
accounts of mental health pathway development in the UK have focused
upon schizophrenia (Jones, 1999, 2000) and dementia (Hall, 2000, 2001).
One multi-professional team described their perceptions of a dementia
assessment care pathway pilot.
• Team members corroborated many benefits of pathways expressed in
the literature; i.e., increased efficiency, role clarification, evidence-based
practice, professionalism, improved teamworking, enhanced communication,
easier access to information.
• The effectiveness of the pathway was viewed as dependent upon a
number of variables – the team, the patient group and available resources.
For example, when equipment or particular specialists were not available,
care was no further enhanced. The pathway merely indicated the
deficiency and during the period of the pilot the pathway did not effect
any improvement when such problems occurred.
• Recording and examining variances had proved to be stressful and frustrating
for individuals. Not accustomed to making known limitations