Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists
-
This paper describes aspects of the child and adolescent benchmarking forums that were part of the National Mental Health Benchmarking Project (NMHBP). These forums enabled participating child and adolescent mental health organizations to benchmark themselves against each other, with a view to understanding variability in performance against a range of key performance indicators (KPIs). ⋯ Benchmarking has the potential to illuminate intra- and inter-organizational performance in the child and adolescent context.
-
This second paper follows an exploration of the nature of blame and addresses the balance between a 'blame-free' health culture and appropriate accountability. This paper aims to define and describe accountability as a key component of clinical governance and a responsive, fair and transparent health culture. ⋯ The necessary conditions for an accountable, responsive, fair and transparent health culture are proposed.
-
Australas Psychiatry · Feb 2011
Pharmacological treatment of behavioural and psychological symptoms of dementia in psychogeriatric inpatient units.
This study involved an examination of the current patterns of pharmacological treatment of patients with behavioural and psychological symptoms of dementia (BPSD) in psychogeriatric inpatient units. ⋯ The broad range of medications used to treat BPSD, the relatively modest place of dementia-specific drugs in this patient group, and the co-prescribing of more than one psychotropic agent in the majority of patients support the prevailing impressions that BPSD are difficult to treat and that there is no consistently effective or superior medication or drug group.
-
Australas Psychiatry · Oct 2010
Clinical decisions in psychiatry should not be based on risk assessment.
Risk assessments that place patients in high or low risk categories have been widely adopted by mental health services in an attempt to reduce the harms associated with psychiatric disorders. This paper examines the effects of categorization based on the results of a risk assessment. ⋯ Patients who are classified as high risk share the cost of efforts to reduce harm in the form of additional treatment and restrictions, although the majority will not go on to commit a harmful act. Clinical decisions made on the basis of risk assessment also divert resources away from patients classified as low risk, even though a significant proportion do go on to a commit harmful act. We argue that psychiatric professionals should discuss the risks of treatment and of non-treatment with patients (or with their substitute decision-makers) and should maintain a duty to warn about the consequences of not having treatment. However, assessment of risk of harm should not form the basis for clinical decision making. We should aim to provide optimal care according to the treatment needs of each patient, regardless of the perceived risk of adverse events.