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Published Online: August 2013

Does the Redesign of a Psychiatric Inpatient Unit Change the Treatment Process and Outcomes?

Karen A. Urbanoski, Ph.D., Benoit H. Mulsant, M.D., Gabriela Novotna, Ph.D., Sahar Ehtesham, H.B.Sc., and Brian R. Rush, Ph.D.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 64, Number 8
https://doi.org/10.1176/appi.ps.004532012
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Abstract

Objective

This study investigated whether ward atmosphere mediated the associations between the physical and therapeutic characteristics of an inpatient ward and patient outcomes.

Methods

Individuals (N=290) receiving inpatient care for mood and anxiety disorders before and after an extensive renovation project were surveyed about ward atmosphere, quality of life, and treatment satisfaction. Global functioning at admission and discharge and other clinical characteristics were obtained from patients’ charts.

Results

After the redesign, participants perceived improved ward atmosphere, and the improvement was associated with greater treatment satisfaction and quality of life. Change in global functioning was independent of ward atmosphere.

Conclusions

Efforts to improve the inpatient environment by supporting patient autonomy, peer support, and practical skill development may be expected to meet with improved outcomes, at least for quality of life and satisfaction with treatment. These findings are consistent with patient-centered design as well as with broader perspectives on recovery-oriented services.

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Information & Authors

Information

Published In

Go to Psychiatric Services
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Cover: Summer Afternoon, by William Dean Fausett, 1943. Oil and tempera on masonite, 30 × 38 inches. Collection of the San Antonio Art League and Museum, San Antonio, Texas.

Psychiatric Services
Volume 64 • Number 8 • August 2013
Pages: 804 - 807
PubMed: 23903606

History

Published in print: August 2013
Published online: 15 October 2014

Authors

Affiliations

Karen A. Urbanoski, Ph.D.
Dr. Urbanoski, Dr. Mulsant, and Dr. Rush are affiliated with the Centre for Addiction and Mental Health, where Dr. Urbanoski and Dr. Rush are with the Health Systems and Health Equity Research Unit, University of Toronto, T309, 33 Russell St., Toronto, Ontario M5S 2S1, Canada (e-mail: [email protected]). Dr. Urbanoski is also with the Dalla Lana School of Public Health, and Dr. Mulsant and Dr. Rush are also with the Department of Psychiatry, University of Toronto. Dr. Novotna is with the Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada. Ms. Ehtesham is with the Department of Endocrinology, Hospital for Sick Children, Toronto.
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Benoit H. Mulsant, M.D.
Dr. Urbanoski, Dr. Mulsant, and Dr. Rush are affiliated with the Centre for Addiction and Mental Health, where Dr. Urbanoski and Dr. Rush are with the Health Systems and Health Equity Research Unit, University of Toronto, T309, 33 Russell St., Toronto, Ontario M5S 2S1, Canada (e-mail: [email protected]). Dr. Urbanoski is also with the Dalla Lana School of Public Health, and Dr. Mulsant and Dr. Rush are also with the Department of Psychiatry, University of Toronto. Dr. Novotna is with the Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada. Ms. Ehtesham is with the Department of Endocrinology, Hospital for Sick Children, Toronto.
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Gabriela Novotna, Ph.D.
Dr. Urbanoski, Dr. Mulsant, and Dr. Rush are affiliated with the Centre for Addiction and Mental Health, where Dr. Urbanoski and Dr. Rush are with the Health Systems and Health Equity Research Unit, University of Toronto, T309, 33 Russell St., Toronto, Ontario M5S 2S1, Canada (e-mail: [email protected]). Dr. Urbanoski is also with the Dalla Lana School of Public Health, and Dr. Mulsant and Dr. Rush are also with the Department of Psychiatry, University of Toronto. Dr. Novotna is with the Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada. Ms. Ehtesham is with the Department of Endocrinology, Hospital for Sick Children, Toronto.
View all articles by this author
Sahar Ehtesham, H.B.Sc.
Dr. Urbanoski, Dr. Mulsant, and Dr. Rush are affiliated with the Centre for Addiction and Mental Health, where Dr. Urbanoski and Dr. Rush are with the Health Systems and Health Equity Research Unit, University of Toronto, T309, 33 Russell St., Toronto, Ontario M5S 2S1, Canada (e-mail: [email protected]). Dr. Urbanoski is also with the Dalla Lana School of Public Health, and Dr. Mulsant and Dr. Rush are also with the Department of Psychiatry, University of Toronto. Dr. Novotna is with the Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada. Ms. Ehtesham is with the Department of Endocrinology, Hospital for Sick Children, Toronto.
View all articles by this author
Brian R. Rush, Ph.D.
Dr. Urbanoski, Dr. Mulsant, and Dr. Rush are affiliated with the Centre for Addiction and Mental Health, where Dr. Urbanoski and Dr. Rush are with the Health Systems and Health Equity Research Unit, University of Toronto, T309, 33 Russell St., Toronto, Ontario M5S 2S1, Canada (e-mail: [email protected]). Dr. Urbanoski is also with the Dalla Lana School of Public Health, and Dr. Mulsant and Dr. Rush are also with the Department of Psychiatry, University of Toronto. Dr. Novotna is with the Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada. Ms. Ehtesham is with the Department of Endocrinology, Hospital for Sick Children, Toronto.
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