A programme theory for liaison mental health services in England
dc.contributor.author | House, A | |
dc.contributor.author | Guthrie, E | |
dc.contributor.author | Walker, A | |
dc.contributor.author | Hewsion, J | |
dc.contributor.author | Trigwell, P | |
dc.contributor.author | Brennan, C | |
dc.contributor.author | Crawford, M | |
dc.contributor.author | Murray, CC | |
dc.contributor.author | Fossey, M | |
dc.contributor.author | Hulme, C | |
dc.contributor.author | Martin, A | |
dc.contributor.author | Quirk, A | |
dc.contributor.author | Tubeuf, S | |
dc.date.accessioned | 2019-06-25T14:07:17Z | |
dc.date.issued | 2018-09-27 | |
dc.description.abstract | Background: Mechanisms by which liaison mental health services (LMHS) may bring about improved patient and organisational outcomes are poorly understood. A small number of logic models have been developed, but they fail to capture the complexity of clinical practice. Method: We synthesised data from a variety of sources including a large national survey, 73 in-depth interviews with acute and liaison staff working in hospitals with different types of liaison mental health services, and relevant local, national and international literature. We generated logic models for two common performance indicators used to assess organisational outcomes for LMHS: response times in the emergency department and hospital length of stay for people with mental health problems. Results: We identified 8 areas of complexity that influence performance, and 6 trade-offs which drove the models in different directions depending upon the balance of the trade-off. The logic models we developed could only be captured by consideration of more than one pass through the system, the complexity in which they operated, and the trade-offs that occurred. Conclusions: Our findings are important for commissioners of liaison services. Reliance on simple target setting may result in services that are unbalanced and not patient-centred. Targets need to be reviewed on a regular basis, together with other data that reflect the wider impact of the service, and any external changes in the system that affect the performance of LMHS, which are beyond their control. | en_GB |
dc.description.sponsorship | National Institute for Health Research (NIHR) | en_GB |
dc.identifier.citation | Vol. 18, article 742 | en_GB |
dc.identifier.doi | 10.1186/s12913-018-3539-2 | |
dc.identifier.grantnumber | HS&DR programme (project reference 13/58/08) | en_GB |
dc.identifier.uri | http://hdl.handle.net/10871/37667 | |
dc.language.iso | en | en_GB |
dc.publisher | BMC | en_GB |
dc.rights | © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. | en_GB |
dc.subject | Consultation-liaison psychiatry | en_GB |
dc.subject | Liaison mental health services | en_GB |
dc.subject | Theories of change | en_GB |
dc.subject | Logic models | en_GB |
dc.subject | Programme theory | en_GB |
dc.title | A programme theory for liaison mental health services in England | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2019-06-25T14:07:17Z | |
dc.identifier.issn | 1472-6963 | |
dc.description | This is the final version, also available from BMC via the DOI in this record. | en_GB |
dc.identifier.journal | BMC Health Services Research | en_GB |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | en_GB |
dcterms.dateAccepted | 2018-09-13 | |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2018-09-13 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2019-06-25T14:05:32Z | |
refterms.versionFCD | VoR | |
refterms.dateFOA | 2019-06-25T14:07:20Z | |
refterms.panel | A | en_GB |
refterms.depositException | publishedGoldOA |
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(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.