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Development of a European Measure of Best Practice for People with Long Term Mental Illness in Institutional Care
This study sought to develop a toolkit for assessing the quality of care in longer term mental health facilities in European countries, based in hospital and the community. Internationally agreed domains were developed through a systematic review of the international literature, a review of national or regional care standards across the ten partner countries and the results of Delphi exercises with key stakeholder groups (service users, carers, mental health professionals and advocates) in partner countries. The toolkit was refined through the course of the study to maximise a) its reliability b) its usability c) its ability to deliver assessments that translate into action plans within each country’s established systems of change at local, regional and national level. A health economic analysis was conducted to examine the toolkit’s ability to provide sufficient information for an assessment of an institution’s “value for money”. The toolkit was also cross-validated against service users’ quality of life, autonomy and markers of recovery to test whether it could deliver a proxy-measure of the promotion of individuals’ human rights and recovery. The final product of the project is a web based toolkit called the Quality Indicator for Rehabilitative Care (QuIRC) which assesses the living conditions and care that a unit provides and the degree to which it promotes the human rights and social inclusion of its residents. The QuIRC is a self-report tool completed by the unit manager. It uses a computerised algorithm to produce individualised, printed reports which detail the unit’s performance on seven domains of care (living environment; therapeutic environment; treatments and interventions; promotion of service users’ self-management and autonomy; promotion of service users’ human rights; promotion of service users’ contact with family and community/social inclusion; the degree of Recovery based practice). These are plotted on a radar chart and the results for similar units in the same country are also shown for comparison. Further text provides more detail about the results and the areas of care the unit could focus on to improve their results.
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