The Application of Case Management in Complex Schizophrenic Patients: Inpatient Psychiatric Ward, Surin Hospital

Abstract

Objective: To examine the effect of case management on psychiatric symptoms and readmission rate of complex schizophrenia patients in psychiatric ward; Surin Hospital.
Setting: inpatient Psychiatric Ward, Surin Hospital
Study design: Independent study
Patient and Method: Ten patients who were diagnosed schizophrenia and demonstrated complicated problems were recruited into the study. The study was conducted during February 1 to April 30, 2009. The current intervention was based on the continuous quality improvement framework. The hospital-based case management service model and the primary nurse case management model were used. The main structure of case management includes collaboration team, care map, case manager and encompassing a 6 step process of assessment, problem identification, planning, implementation, monitoring, and evaluation.
Results: The study result showed that, after the intervention, patients were increased in their general functions abilities, and had lower psychiatric symptoms indicating by decreased BPRS score, an increased knowledge about schizophrenia and self management. The patient’s relatives had also gain the knowledge score about schizophrenia and patient care at the high level. Most patients and the relatives were satisfied with the service at high level. The average length of hospital stay was decreased. The participated patients did not relapse within 28 days after being discharged and most of the multidisciplinary team members strongly agreed with did not the implementation of case management and this intervention program increases their workload.
Conclusion: A case management program can reduce the rate of re-admission for schizophrenic patients, The patients and relative were statistic with this intervention program at highest level
Key words: complex schizophrenic patients, Case management.