Characteristics of Productive and Unproductive Unit Systems in VA Psychiatric Hospitals

Psychiatric hospitals with unit systems differ in productivity, as measured by an increase in turnover rates and a decrease in long-term residents. A study of 39 VA hospitals revealed that the most productive had special placement programs, smaller treatment units, and competition between unit staff. The ten most productive hospitals also had more applied research, a higher percentage of patients on unclassified units, and a higher ratio of social workers to patients than did the ten least productive hospitals. Despite generally favorable staff reaction to the unit system and increased hospital productivity, there are signs that VA hospitals are moving toward more specialized treatment wards.