The Resource Hub: an innovative e-information service delivery model addressing mental health knowledge management.

OBJECTIVE: This paper outlines the development of the Resource Hub, an intranet-based electronic information service designed to improve knowledge management and staff satisfaction in the Inner North Brisbane Mental Health Service, Royal Brisbane and Women's Hospital, Metro North Health Service District. METHOD: The Resource Hub was launched in April 2007. It encompasses a large range of electronically stored resources and clinically relevant information, including direct links to approved internet sites, psychoeducation resources, fact sheets, resource lists and details of current service research projects. The Hub will continue to expand over time, improving access to clinical service delivery resources. RESULTS: A significant review conducted in April 2008 resulted in modifications to further improve the content and design of the Hub. Ongoing evaluation incorporates regular usage monitoring and stakeholder satisfaction surveys. CONCLUSIONS: The Resource Hub is a service delivery innovation that effectively addresses mental health service knowledge management issues. It is a strategy that could readily be transferred to other district mental health services and to health services in general.

The Resource Team: an innovative service delivery support model for mental health services.

OBJECTIVE: This paper outlines the development of the Resource Team, an innovative service delivery model supporting clinical services at the Inner North Brisbane Mental Health Service, Royal Brisbane and Women's Hospital Health Service District. The team aims to provide a base for specialist mental health support staff, improve knowledge management and support the development of meaningful community partnerships. METHOD: Development of the team included a literature review and consultation with internal and external stakeholders. From this, the objectives, roles and functions of the team were clarified and disseminated to stakeholders. RESULTS: The team currently encompasses 12 positions and has initiated a number of programs and service developments. These include improved IT management of clinical resources and the development of partnerships with the community and non-government sectors. CONCLUSIONS: The Resource Team effectively coordinates specialist clinical support positions, addresses knowledge management issues and facilitates meaningful engagement with the community and non-government sectors. The model could easily be applied in other mental health and general health services.

"GP Psych Opinion": evaluation of a psychiatric consultation service.

OBJECTIVE: To evaluate a hospital-based psychiatric consultation service for patients referred by general practitioners (GPs), and the effect on its use of a focused marketing strategy aimed at GPs. DESIGN AND SETTING: Postal survey of GPs in the catchment area (inner north Brisbane, Queensland), September to November 2003; and assessment of referrals, March to August 2003. MAIN OUTCOME MEASURES: Patient referrals, satisfaction among GPs who had referred, and awareness and opinions of the service among GPs who had not referred, compared with results of a similar survey conducted before marketing. RESULTS: In the 6 months after marketing, 43 patients were referred by 23 GPs, an average of 7.2 patients per month, compared with 2.5 per month in the first 12 months of the service. Survey responses were received from 13 of 36 GPs who had referred patients and 97 of 282 GPs who had not (response rate, 35%). Satisfaction among GPs who had referred remained high, and 12/13 felt the service should continue. Among GPs who had not referred, 76% were aware of the service, up from 26% in the previous survey, and 99% liked the concept of the service. CONCLUSION: Given the ongoing low utilisation of this service, we question whether this model is accepted by most GPs in our district. Possibly, they prefer more traditional models, where treatment is taken over by psychiatrists in the public or private system. We believe there is a need to increase the capacity and scope of publicly funded services to treat mental health problems.

A tale of three pathways: the experience of RBWH Mental Health.

OBJECTIVES: Australian research has identified that there are significant variations between service providers in terms of clinical management of patients with comparable presenting problems. Internal audits within the facility at Royal Brisbane and Women's Hospital revealed that these variations occurred between wards, treating teams and psychiatric consultants. Given the increasing emphasis on evidence-based practice, it was decided that the literature should be reviewed to determine what the standard of care should be. The paper then examines how clinical pathways for psychosis and for depression were developed and how they eventually evolved into an acute inpatient pathway. It identifies the framework used and examines important aspects relating to the adaptation of these frameworks to mental health issues. The process for the development and implementation of the clinical pathway is discussed. Recommendations for their future use in a mental health setting are also presented. CONCLUSIONS: Mental Health care is complex. For this reason, mental health clinical pathways have to remain flexible and innovative. With the present project, it was found that the pathways were not suited for specific diagnoses so that they evolved into a single acute inpatient pathway.