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IIPR Studies 5.10.23

 

  1. LEC Study: Beginning in 2019 patients admitted to Ancora Psychiatric Hospital complete a form called the Life Events Checklist (LEC). This form asked patients to identify with a Yes or a No what kind of aversive life events they may have experienced in the past and if any of these events are currently bothering them.  This information is then made available to the patient’s treatment team for use if developing a comprehensive treatment plan.  The study analyses this aggregate deidentified data to determine the relationship of LEC checklist responses with hospital demographic data.  The goal is to assess if exposure to multiple or specific aversive life events is associated with a particular racial profile, longer or more frequent hospital stays, more untoward events, more need for 1 to 1 observation, more restraints and or more violent behaviors. The value of this information is to better predict who may require additional support upon admission to avoid negative hospital events like restraints and to prevent a negative hospital trajectory such as extended length of hospitalization or frequent readmissions.

 

  1. Mall Delphi: A Psychiatric Inpatient Treatment Mall involves the provision of psychiatric rehabilitation interventions and a range of other psychotherapies in a centralized inpatient location with increased elements of consumer choice and empowerment. There is preliminary evidence that aspects of this approach may offer improved outcomes for hospitalized individuals over unit-based treatment (Bartholomew & Cook, 2013). However, there is currently little agreement on the critical ingredients of a best practice inpatient treatment mall. This study used an iterative Delphi survey approach to identify, validate, and measure the critical ingredients of a Mall. A series of three surveys were sent to knowledgeable participants in 25 State Psychiatric Hospitals in 18 states. The first survey elicited 393 statements about inpatient Malls.  The responses were coded into 15 critical Mall ingredients in the 4 domains of Centralization, Philosophy, Management, and Programming.  The second survey sent these 15 ingredients back to the participants to determine if consensus existed on the criticality of the 15 items.  The third survey asked what outcomes each of the ingredients might be associated with and for strategies to measure the ingredients.  Results suggest that Malls may have critical ingredients suitable for measurement and that more of these ingredients may be associated with important outcomes for patients and staff. Confounds of this study and future directions are addressed.

 

  1. Trauma Informed Universal Precautions Implementation Study (TI UP): All Staff of the NJ State Psychiatric Hospital system are required to take a 1 hour training on Trauma Informed Universal Precautions and complete a brief survey afterwards. This study analyses information from this survey on staff’s suggestions on how to implement TI UP more broadly. This information is intended for use as a “nudge” for hospital leadership to take further steps beyond just the training to support the use of the TI universal precautions.

 

  1. Competency Restoration: State Psychiatric hospitals are increasingly treating patients with legal involvement. One aspect of this task is returning patient to competency to stand trial.  This study seeks to identify best practices in competency restoration.

 

  1. Discharge Hesitancy: One problem facing State Psychiatric Hospitals are patients who are “hesitant” to participate in the discharge process.  This study seeks to validate a scale called the Discharge Hesitancy Scale for use in identifying best practice interventions to support this group to successfully participate in the discharge process.

 

  1. CRIPA : The Civil Rights of Institutionalized Persons Act (CRIPA) was  enacted in 1980 to provide DOJ with the statutory authority to bring cases to protect institutionalized persons. CRIPA is intended to help eliminate unlawful conditions of confinement for detained and incarcerated individuals. Through express authority granted to the Attorney General, CRIPA gives the Civil Rights Division of the U.S. Department of Justice (DOJ) the power to bring actions against State or local governments for violating the civil rights of persons institutionalized in publicly operated facilities. Since 1980 there have been 30 lawsuits of states involving State Psychiatric Hospitals.  This study seeks to identify the specific civil rights being violated and the DOJ’s suggested remedies. The goal is to identify best practices interventions in inpatient settings that protect the civil rights of patients residing there.