Biomedical subjects

W P Buick

Publications and source records attributed to W P Buick.

4 recordsLinked to original sources

PubMed1993

Initial evaluation of reorganized hospitalization services in a community mental health center.

OBJECTIVE: Two locked inpatient units at an inner-city community mental health center were reorganized as a hospitalization service consisting of a 22-bed intensive care inpatient unit, an acute-treatment day hospital for 20 patients, and a 23-bed transitional residence program. Levels of functioning of hospitalized patients treated before and after the reorganization were compared to determine if the reorganized program as a whole was more effective clinically than the two inpatient units had been. METHODS: The authors retrospectively compared levels of functioning at discharge of random samples of 10 percent of patients treated in the ten months before the reorganization (N = 66) and 10 percent of the intensive care and day hospital patients treated in the same ten calendar months afterward (N = 78). They also compared data on episodes of seclusion and restraint and on patient flow in the two time periods. RESULTS: The mean functional level of intensive care and day hospital patients treated in the reorganized service was significantly higher than the level of inpatients treated before. The mean duration of episodes of seclusion, but not of restraint, decreased significantly. Total service admissions and readmissions increased from 493 to 603. CONCLUSIONS: The reorganized service encouraged patients to function at higher levels. However, such a program must be affiliated with a diversified and well-functioning outpatient service that can divert some potential inpatients to appropriate alternative treatments and help move patients out of the day hospital-residential program when they are stabilized.

Activities of Daily Living↗

PubMed1990

Identification of patients with coexisting alcohol and cocaine disorders at a community mental health center.

To measure the prevalence of cocaine abuse at a community mental health center's inpatient alcohol unit, a 20 item document was used to obtain information from the medical records of 162 patients admitted from January 1988 through July 1988. The data collected were analyzed to evaluate the assessment, diagnosis, treatment and referral of patients with coexisting alcohol and cocaine disorders. Of the 162 patients in the sample, 154 (95%) had a diagnosis of alcohol abuse/withdrawal and five (3%) had a diagnosis of cocaine abuse. Fifty-five patients had used cocaine for at least one year and 39 (24%) of the patients had a positive laboratory test for the drug upon admission. Eighty-six patients, over 53 percent of the sample, met the DSM III-R criteria for cocaine abuse, but only five (3%) of the patients were referred to substance abuse clinics or support groups upon discharge. These findings highlight the inadequate diagnosis, treatment and follow-up of patients with coexisting alcohol and cocaine disorders.

Alcoholism↗

PubMed1990

Patient satisfaction.

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Community Mental Health Centers↗

PubMed1989

Impact of organizational change on the intake, referral and treatment of outpatients at a community mental health center.

The authors evaluated two indices of services for 349 outpatients who requested an initial appointment for screening and evaluation at a community mental health center over a one-month period in April of 1981, 1984, and 1988. Intake waiting time after initial screening and evaluation was 15.2 treatment days in 1981, 15.4 treatment days in 1984 and reduced to 2.7 treatment days in 1988. For patients who were referred for continued outpatient treatment, the dropout rates were reduced from 54.3 percent in 1981, to 28.51 percent in 1984 and further reduced to 19.19 percent in 1988. A divisional structure was designed with the purpose of reducing organizational barriers in order to provide greater access to services and to enhance continuity of care to patients. These results suggest that systematic organizational changes and the implementation of clearly defined clinical and administrative policies and procedures can impact favorably upon the intake, referral and treatment of outpatients.

Community Mental Health Centers↗