New initiative to improve care transitions for mental health consumers

Ensuring that mental health and addiction service consumers receive continuous quality care between providers is the latest initiative from the Health Quality & Safety Commission.

The new project from the mental health and addiction programme team, Connecting care, will focus on service transitions, the name for the coordinated transfer of care between one health care or social service provider and another.

Transitions can be complex, and poor transitions can result in negative consequences for the health and wellbeing of consumers, their families and whānau, as well as impacting service providers in many ways.

Improving the quality of service transitions was identified by the mental health and addiction sector in 2017 as one of the five priority areas requiring a quality improvement focus.

Connecting care will see health and social service providers, consumers, and their families and whānau working together using a quality improvement approach to improve the way that consumers experience transitioning between providers.

Work will begin in August with two workshops being held on 21 and 22 August (in Auckland and Wellington respectively). There, teams of health and social service providers from DHBs, NGOs and primary care will work with consumers, and their families and whānau, to identify and establish pathways for improving transitions.

Three specific service transitions have been identified as a priority under Connecting care, and each DHB-led team will target one of the following transitions:

• from DHB specialist services to DHB community teams
• from DHB specialist services to primary care and/or NGO services
• from youth to adult services.

Ensuring continuous quality care between transitions has the potential to deliver a raft of positive benefits, including improved use of resources, increased consumer satisfaction, better rates of recovery and an increase in consumer resilience.

Speaking about Connecting care, Dr Clive Bensemann, clinical lead for the Commission’s mental health and addiction programme, said: ‘We know that service transitions can be complex and that many factors affect their efficiency and effectiveness. Yet when a person leaves the care of one provider, we need to make sure they continue to receive safe, high quality care throughout.’

Mental health consumer Jill [i] recalls how her negative experiences when transitioning between providers placed her in vulnerable position.

‘The community clinical team decided I needed respite care and found me a bed in a community respite service. I arrived at the given address, at the arranged time, but staff were not expecting me and had no knowledge that I was coming.

‘They showed me to a room and left me there for one and a half hours. No offer of a drink, no one came to see me, no one spoke to me. I was hearing distressing voices and my mood was really low. I still didn’t know if I was even in the right place. I got scared and ended up leaving the NGO-run respite.

‘Down the road I thought ... I have nowhere else to go! I rang my nurse asking her if I should go home. She was horrified that they hadn’t even addressed me or welcomed me, she begged me to go back. So, I went back, knocked on the door and the team leader answered.

‘I asked "am I in the right place?". He (the team leader) said "We haven’t received the correct paperwork" and that I should have arrived with a nurse to "hand me over". By this time, I was upset. He let me into the lounge and offered me a drink. The clinical team arrived 30 minutes later, to hand over.’

Jill’s story, and many others of those affected by negative transition experiences, will be shared at the August workshops to help inform providers and ensure that consumer care is at the heart of any effort to improve transitions.

Connecting care is the second national project to be introduced by the mental health and addiction quality improvement programme; a five-year programme established to identify, select and implement quality improvement initiatives and build quality improvement capability in the mental health and addiction sector.

 [i] Name changed to protect identity of consumer.