Does major renovation of inpatient units in psychiatry improve treatment outcomes?
Most of us probably assume that improving the physical characteristics of a treatment environment in an inpatient unit should help increase the chance of treatment success. However, there is little information available showing that such renovations of a psychiatry unit improves treatment.
CAMH Scientist Karen Urbanoski and her colleagues addressed this question by taking advantage of the construction of a new CAMH inpatient unit for the treatment of mood and anxiety disorders. Prior to the redesign, the unit consisted of a central nursing station, lounge area, shared bathrooms, and two-person rooms. After construction of the units, clients had the option of either staying in the original unit, or the new unit that was much more client-centred with private rooms with ensuite bathrooms and showers, a kitchen, private visitation room, and nursing stations on only two of the four floors.
As reported in Psychiatric Services, 290 patients were surveyed. Some stayed in the old unit before the redesign, and others were inpatients on the new unit.
The investigators found that after the redesign, patients had improved treatment satisfaction and greater quality of life, which was associated with the new inpatient unit “atmosphere.” However, an assessment of patients’ “global functioning” did not show any association with changes in the unit’s atmosphere. Global functioning measures a person’s ability to function in school, work and with other daily activities.
The researchers suggest that global functioning scores might not have improved after the renovation because scores of patients recruited after the design were higher at admission than scores of those recruited before the redesign—and there was little room for further improvement of scores.
Dr. Urbanoski emphasizes that her study is only preliminary, but it hopefully will lead to other studies aimed at determining whether major, and costly, renovations of inpatient units in psychiatry improve treatment.