'Talking a different language': an exploration of the influence of organizational cultures and working practices on transition from child to adult mental health services.
BMC Health Services Research
This is the final version of the article. Available from BioMed Central via the DOI in this record.
BACKGROUND: Organizational culture is manifest in patterns of behaviour underpinned by beliefs, values, attitudes and assumptions, which can influence working practices. Cultural factors and working practices have been suggested to influence the transition of young people moving from child to adult mental health services. Failure to manage and integrate transitional care effectively can lead to young people losing contact with health and social care systems, resulting in adverse effects on health, well-being and potential. METHODS: The study aim was to identify the organisational factors which facilitate or impede transition of young people from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS) from the perspective of health professionals and representatives of voluntary organisations. Specific objectives were (i) to explore organizational cultures, structures, processes and resources which influence transition from child to adult mental health services; (ii) identify factors which constitute barriers and facilitators to transition and continuity of care and (iii) make recommendations for service improvements. Within an exploratory, qualitative design thirty four semi-structured interviews were conducted with health and social care professionals working in CAMHS and AMHS in four NHS Mental Health Trusts and four voluntary organizations, in England. RESULTS: A cultural divide appears to exist between CAMHS and AMHS, characterized by different beliefs, attitudes, mutual misperceptions and a lack of understanding of different service structures. This is exacerbated by working practices relating to communication and information transfer which could impact negatively on transition, relational, informational and cross boundary continuity of care. There is also evidence of a cultural shift, with some positive approaches to collaborative working across services and agencies, involving joint posts, parallel working, shared clinics and joint meetings. CONCLUSIONS: Cultural factors embodied in mutual misperceptions, attitudes, beliefs exist between CAMHS and AMHS. Working practices can exert either positive or negative effects on transition and continuity of care. Implementation of shared education and training, standardised approaches to record keeping and information transfer, supported by compatible IT resources are recommended, alongside management strategies which evaluate the achievement of outcomes related to transition and continuity of care.
The TRACK study was funded by the National Institute of Health Research (NIHR) Service and Delivery Organisation (SDO) programme. (http://www.netscc.ac.uk/hsdr/projdetails.php?ref=08-1613-117). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the NIHR SDO programme or the Department of Health.
Research Support, Non-U.S. Gov't
Vol. 13, pp. 254 -
Place of publication
Showing items related by title, author, creator and subject.
The GP Patient Survey for use in primary care in the National Health Service in the UK--development and psychometric characteristics Campbell, John; Smith, P; Nissen, S; Bower, Peter; Elliott, Marc; Roland, M (BioMed Central, 2009-08-22)BACKGROUND: The UK National GP Patient Survey is one of the largest ever survey programmes of patients registered to receive primary health care, inviting five million respondents to report their experience of NHS primary ...
Can municipality-based post-discharge follow-up visits including a general practitioner reduce early readmission among the fragile elderly (65+ years old)? A randomized controlled trial Thygesen, LC; Fokdal, S; Gjørup, T; Taylor, RS; Zwisler, A-D; Prevention of Early Readmission Research Group (Taylor & Francis, 2015-06-10)OBJECTIVE: To evaluate how municipality-based post-discharge follow-up visits including a general practitioner and municipal nurse affect early readmission among high-risk older people discharged from a hospital department ...
Black, N; Burke, L; Forrest, CB; Sieberer, UHR; Ahmed, S; Valderas, JM; Bartlett, SJ; Alonso, J (Springer Verlag (Germany), 2015-11-15)While the use of PROs in research is well established, many challenges lie ahead as their use is extended to other applications. There is consensus that health outcome evaluations that include PROs along with clinician-reported ...