Health Quality Ontario’s Schizophrenia: Care for Adults in Hospitals Quality Standard addresses care for adults aged 18 years and older with a primary diagnosis of schizophrenia (including related disorders such as schizoaffective disorder) who are seen in an emergency department or admitted to an inpatient setting.
The quality standard includes 11 quality statements addressing areas that have high potential for improving the quality of care in Ontario for people with a diagnosis of schizophrenia in hospitals.
Below is a sample of tools that may help you with the implementation of the quality statements into practice. Please also see the Schizophrenia: Care for Adults in Hospitals Quality Standard for more tools and information, and its partnering quality standard, Schizophrenia: Care in the Community for Adults.
Are there other tools or resources you use? Do you have experience implementing these tools? If you have any feedback about any of these tools, please use the comments section below to share!
Tools and Resources for Each Quality Statement
Quality Statement 1. Comprehensive Interprofessional Assessment: Adults who are admitted to an inpatient setting with a primary diagnosis of schizophrenia undergo a comprehensive interprofessional assessment that informs their care plan.
Quality Statement 2. Screening for Substance Use: Adults who present to an emergency department or in an inpatient setting with a primary diagnosis of schizophrenia are assessed for substance use and, if appropriate, offered treatment for concurrent disorders.
Quality Statement 3. Physical Health Assessment: Adults who are admitted to an inpatient setting with a primary diagnosis of schizophrenia undergo a physical health assessment focusing on conditions common in people with schizophrenia.
- Metabolic Monitoring Tool—an interactive web tool from the Early Psychosis Intervention Ontario Network that aims to promote metabolic monitoring for people with mental illness
Quality Statement 4. Promoting Physical Activity and Healthy Eating: Adults who are admitted to an inpatient setting with a primary diagnosis of schizophrenia are offered interventions that promote both physical activity and healthy eating.
- Positive Cardiometabolic Health Resource—this intervention framework
for people experiencing psychosis and schizophrenia is used by the National
Health Services in the UK, but could be adapted to the Ontario context
Quality Statement 5. Promoting Smoking Cessation: Adults who are admitted to an inpatient setting with a primary diagnosis of schizophrenia are offered behavioural and pharmacological interventions to alleviate nicotine-withdrawal symptoms and to help them reduce or stop smoking tobacco.
- Ottawa Model for Smoking Cessation—a program by the Ottawa Heart Institute that ensures all patients who smoke are identified and offered evidence-based counseling and smoking cessation medications
- Smokers Helpline—a resource by the Canadian Cancer Society that provides free and personalized tools to help people quit smoking successfully
Quality Statement 6. Treatment with Clozapine: Adults who are admitted to an inpatient setting with a primary diagnosis of schizophrenia who have failed to respond to previous adequate trials of treatment with two antipsychotic medications are offered clozapine.
- Quorum Post on the Royal—a Quorum post spotlighting how The Royal Mental Health Centre improved the safe use of clozapine within a complex community mental health system
Quality Statement 7. Treatment with Long-Acting Injectable Antipsychotic Medication: Adults who are admitted to an inpatient setting with a primary diagnosis of schizophrenia are offered the option of a long-acting injectable antipsychotic medication.
There are no specific tools identified for this statement.
Quality Statement 8. Cognitive Behavioural Therapy: Adults who are admitted to an inpatient setting with a primary diagnosis of schizophrenia are offered individual cognitive behavioural therapy for psychosis either in the inpatient setting or as part of a post-discharge care plan.
Quality Statement 9. Family Intervention: Adults who are admitted to an inpatient setting with a primary diagnosis of schizophrenia are offered family intervention.
- Schizophrenia: An Information Guide—a guide by the
Centre for Addiction and Mental Health intended for people with schizophrenia,
their families and friends, and anyone else interested in better understanding
the illness and what it is like to experience it
- Services for Families—a list of services
provided by the Schizophrenia Society of Ontario
- Resources and Links—a
resource list compiled by the Schizophrenia Society of Canada that provides
in-depth information about schizophrenia, psychosis and the path to mental
Quality Statement 10. Follow-Up Appointment after Discharge: Adults with a primary diagnosis of schizophrenia who are discharged from an inpatient setting have a follow-up appointment within 7 days.
Quality Statement 11. Transitions in Care: Adults with a primary diagnosis of schizophrenia who are discharged from an inpatient setting have a team or provider who is accountable for communication and the coordination and delivery of a care plan that is tailored to their needs.
Comprehensive Tools and Resources
The following tools and/or resources may apply to more than one quality statement in this quality standard.
- Clinical Practice Guidelines for Schizophrenia—guidelines developed by Ontario Shores Centre for Mental Health Sciences that are intended to assist organizational leaders to implement Clinical Practice Guidelines for the assessment and treatment of schizophrenia
Other Tools and Resources
The following are useful tools and/or resources for this quality standard topic that do not fall under any specific quality statements.
Comment below to describe your experience with these tools or share any others you have found useful!
This post is part of a series about how quality standards can be used to support quality improvement together, and provides a forum for people who are working on adopting the quality standards to share ideas and experiences. The introductory post can be found here.