Partial hospitalization program as a learning organization: Geriatric population diagnosed with schizophrenia disorder considered.

摘要

The population worldwide is on the increase particularly the elderly; it is projected that approximately one in five Americans will be sixty-five years or older in the next twelve years. Therefore, there is an increased need to provide mental health services to the geriatric population due to present trend. Services including medical (e.g., psychiatric), psychological, and social services can be provided at a well-structured partial hospitalization program (PHP), a cost-effective treatment modality, that follows the philosophy of a 'learning organization'. The following concepts are reviewed: the concept of schizophrenia, the purpose and development of the Diagnostic and Statistical Manual of Mental Disorder (DSM), the course of schizophrenia, the differences between symptom clusters, the brain, the influence of genetics, common characteristics, costs, therapeutic interventions, and an overview of PHPs including a brief history and the differences between new program design and existing ones in Dade County, Miami, Fla.; The program design addresses both the administrative component, program development and evaluation, and the clinical component, biopsychosocial philosophy of treatment, and multidisciplinary team approach which follows the philosophy of a learning organization. The program design delineated five distinct phases of development; preliminary, physical layout, pre-working, working, and evaluation phases. Throughout the development of the program design, the philosophy of a learning organization is implemented in order to increase the level of productivity; acceptance, sharing, teamwork, trust, and optimism are essential ingredients for an effective working environment. Multidisciplinary team members are encouraged via formal and informal team meetings, conferences, and on-going training to learn from past experiences including past errors, and from the diversity of perspectives among team members. Brainstorming and open-dialogue are both promoted in a PHP as a learning organization. On the other hand, fragmentation, competition and reactiveness are deterred.; To evaluate the quality and development of program design, the program director appraises the feedback provided by several sources including the outcome of bi-monthly committees' meetings, Florida Department of Children and Families site-inspection, Medicare and quality improvement chart review process. In addition, patients provide valuable feedback via the client satisfaction questionnaire at the time of discharge, sixty days and one year thereafter.; One of the limitations of this program design is that there is no existing PHP in Dade County which follows the philosophy of learning organization; therefore, both the operational definition and the sample for a research study is problematic at this time. Validation of program's assessment tool is necessary in the future. Other studies may concentrate on the efficacy of multidisciplinary teams in PHPs as learning organizations.; This program design, PHP as a learning organization, is a relatively new concept; there are various areas which need further assessment and validation in future research studies.