Evaluation of Recovery-oriented Acute INpatient Mental Healthcare (RAIN-MH)

以恢复为导向的急性住院精神卫生服务支持退伍军人从 通过鼓励疾病自我管理，促进获得 循证治疗，并增加患者参与门诊服务。退伍军人管理局 最近已发出有关推行这些服务的指引。拟议 这项研究将探讨退伍军人和工作人员对以康复为导向的住院服务的看法， 这些服务和退伍军人结果之间的关系（例如，门诊预约 服务和复发）。结果将用于支持进一步实施恢复- 导向的服务，以及完善的方法来衡量实施。 2013年，VHA发布了《住院病人手册》，以规范急性住院精神卫生保健 重点是“以恢复为导向的临床护理，包括工作人员的参与， 参与和赋权，并灌输希望感。”2014年，心理健康办公室 卫生业务部实施了以康复为导向的住院护理的要素， 提供了执行准则。然而，关于这些的摄取知之甚少。 指导方针、站点用于实施这些服务的流程或 对退伍军人或工作人员的影响。 本研究的目的是：1）检查恢复导向服务的实施情况 VHA内; 2）描述实施过程，包括挑战和策略， 克服他们;和3）测试的假设，退伍军人服务的高恢复单位将 更多地参与门诊服务，复发率低于退伍军人 由低回收单位提供服务。 本研究将采用并发三角测量、混合方法设计。高回收率和低回收率 将通过在线调查确定单位。关于实施回收的数据- 面向的元素，实施过程和退伍军人的结果将收集使用- 现场观察、行政数据和利益相关者访谈（工作人员和退伍军人）。

Recovery-oriented acute inpatient mental health services support Veterans’ recovery from mental illness and/or addictions by encouraging illness self-management, facilitating access to evidence-based treatments, and increasing patient involvement in outpatient services. The VA has recently issued guidelines regarding the implementation of such services. The proposed study will examine Veteran and staff perspectives of recovery-oriented inpatient services and the relationship between these services and Veteran outcomes (e.g., engagement in outpatient services and relapse). Results will be used to support further implementation of recovery- oriented services as well as refine methods for measuring implementation. In 2013, VHA issued the Inpatient Handbook, to standardize acute inpatient mental healthcare with a focus on “recovery-oriented clinical care that encompasses staff engagement, patient engagement and empowerment, and instilling a sense of hope.” In 2014, the Office of Mental Health Operations operationalized the elements of recovery-oriented inpatient care and provided guidelines for implementation. However, little is known regarding the uptake of these guidelines, the processes sites have used to implement these services, or the impact that implementation has had on Veterans or staff. The aims of this study are to: 1) Examine the implementation of recovery-oriented services within VHA; 2) Describe the implementation process, including challenges and strategies to overcome them; and 3) Test the hypothesis that Veterans served by high recovery units will be more engaged in outpatient services and experience lower relapse rates than Veterans served by low recovery units. The study will use a concurrent triangulation, mixed-methods design. High and low recovery units will be identified using an on-line survey. Data regarding implementation of recovery- oriented elements, implementation processes, and Veteran outcomes will be collected using on- site observation, administrative data, and stakeholder interviews (staff and Veterans).