Patient journey mapping in an open-door psychiatric inpatient unit

Open-door policies in inpatient psychiatric care have been increasingly adopted to enhance patient autonomy and reduce coercive practices. However, systematic methods for evaluating patient experiences in these settings remain limited. This study applied Patient Journey Mapping in an acute psychiatric unit operating a structured, time-limited (6 hours/day) open-door policy to comprehensively analyze the hospitalization experience.

An exploratory sequential mixed-methods design was used. Qualitative data were first collected through focus groups with patients (n = 18), following GRAMMS guidelines, to identify critical touchpoints across the hospitalization journey. Quantitative data were then collected from patients (n = 32) using an adapted Likert-type ordinal scale to assess satisfaction with the identified touchpoints. Data were analyzed using content analysis methods.

The analysis delineated the main phases of hospitalization and identified key experiential touchpoints, including "Moments of Truth," "Moments of Pain," and "Wow Moments," which substantially shaped patients' perceptions of care quality. Open-door policies were perceived as supporting autonomy and reducing psychological distress. However, several challenges remained, particularly regarding the admission process, privacy during medication administration, and communication about structured activities.

Patient Journey Mapping provides a useful patient-centered approach for evaluating experiences in open-door psychiatric inpatient settings. The findings highlight opportunities to optimize service delivery, strengthen therapeutic environments, and support recovery-oriented practices in acute psychiatric care.