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Changes in early psychosis service provision: a file audit
Joanne Gorrell1, Alison Cornish, Chris Tennant
1Department of Psychological Medicine, Royal North Shore Hospital, Sydney, NSW, Australia.
The Australian and New Zealand Journal of Psychiatry
|August 25, 2004
Summary
Specialized early psychosis teams improved care for young people with first-episode psychosis. Services increased guideline-concordant interventions, including psychosocial support and family involvement.
Area of Science:
- Psychiatry
- Mental Health Services Research
Background:
- First-episode psychosis requires specialized, timely interventions.
- Early intervention in psychosis (EIP) services aim to improve outcomes.
- The impact of specialized EIP teams on service delivery needs evaluation.
Purpose of the Study:
- To assess changes in service provision for young people with first-episode psychosis.
- To evaluate the effect of introducing specialized early psychosis teams and staff training.
Main Methods:
- A 27-indicator audit tool was developed based on Australian clinical guidelines.
- Case records of young people with first-episode psychosis before (n=47) and after (n=70) service development were audited.
- Comparison included those treated by specialized teams versus other services.
Main Results:
- Inter-rater reliability was established for 24 of 27 indicators.
- Improvements were noted in psychosocial interventions, prescribing, family support, and continuity of care.
- Clients treated by early psychosis teams were more likely to receive psychoeducation.
Conclusions:
- Specialized early psychosis services enhanced guideline-concordant care.
- Audits are effective for monitoring performance and identifying areas for service improvement.