Part 1: Site description and the type of hypothetical facility The aptitude to provide timely and comprehensive care to the mentally ill patients is of great essence. Such patients are often handled in the psychiatry specialty within the healthcare facility. Psychiatry specialty is a form of medical facility devoted for study, diagnosis, treatment and prevention of mental disorders. The facility serves to improve the health and care for the mental disorder patients. Therefore proper utilization of practices not only requires direct patient care, it equally calls for appropriate utilization of all the availed medical equipments within the facility. Of great essence in the specialty should be psychiatric rehabilitation. Psychiatric rehabilitation facility requires comprehensive utilization so as to realize effectiveness in handling mental disorders. Part 2: Introduction of Issue Most hospitals have need that is not often met both medically and economically. In the psychiatric specialty, patients are normally admitted due to various cases of mental disorder. This condition usually requires thorough treatment and monitory rehabilitation. The medical staff in charge should devote his time to closely monitor the patients soon after medication. In most cases, patients develop same or even more badly mental conditions soon after they are discharged. This may be very dangerous since it occurs without any signaling warning. The nursing staff in the psychiatry specialty cannot keep tracking patients from a distance after they are discharged. Psychiatric rehabilitation centers would better serve the purpose, and limit chances of recurrence. Currently, hospitals concentrate in the medical practices relevant to the in- patient services. “Globally, the mental health resources in countries present a dismal picture of severe shortage and neglect. Often, the resources and services are at 1% to 10% of what is needed.” (MH GAP 6). However, the mentally disabled patients do not only need such medical attention. They need much more of well structured orientation program to completely recover. Rehabilitation Center is planned to address the needs of mentally disabled patients during in-inpatient interventions and after discharge. As a result, when the mentally disabled patients are taken through psychiatric rehabilitation, they will realize a proper recovery platform. As previously highlighted, majority of mentally disabled patients need proper rehabilitation, and not just medical attention. The nursing staffs in psychiatric specialty claims they don think about rehabilitation because their patients are not in need for it. Consequently, patients are placed in very dangerous conditions without rehabilitation process. The mental disorder patients need consistent orientation and monitoring, which is not realistic in ordinary medical procedures. Consistency in monitoring such patients is needed since symptoms can be so severe in a short span after discharge. Patients with mental disorders may show symptoms of disorientation, confusion, changes in mental capacity, agitations, deep sleep, sensitivity to touch, sound or light and delirium. Such patients have to be monitored during the process of fighting withdrawals, especially when reacting to the medication. Failure to include psychiatric rehabilitation specialty in a medical facility causes miscoding and waste to the medical sponsors, who may in turn pay for services not rendered to their clients. Although rehabilitation is most essential, some facilities cannot implement it based its absence. However, this does bring about many issues in the psychiatry specialty and the hospital as a whole. Quality safety is one of the many issues facing the psychiatric specialty in the medical facilities. Any medication procedure administered to the patients should promote safety above all other goals. Cultural safety is a base that lies between the psychiatrist and the nursing team. Each of the team members ought to understand the best standards required, and how to achieve and maintain those standards. Part 3: Evaluation of the Gap between what is known and what still needs to be determined about Psychiatric Rehabilitation Psychiatric departments deploy numerous types of information technology and equipments to monitor patients. So as to take good care of mentally disabled patients, all the equipments must be appropriate. There is a serious startling gap between effective and available services. Inventory must equally go hand in hand with the medical procedures to provide optimal care. The gap points out insufficiency of skilled personnel, facilities, budget, policy and programs for rendering effective psychiatric rehabilitation. “Globally, the mental health resources in countries present a dismal picture of severe shortage and neglect. Often, the resources and services are at 1% to 10% of what is needed.” (mhGAP 6). The project for the Rehabilitation Center is planned to address the needs of mentally disabled patients during in-inpatient interventions and after discharge. The key points considered are budget, infrastructure, management and skilled personnel. Part 4: proposed tasks and goals The project will be completed under the appointed Project Director, who will head the team of general manager, accounts manager, civil and electrical engineers and security manager. The team will monitor the progress of the project work, with daily reports and weekly reviews. Part 5: proposed timelines: 1.Acquisition of land and construction of buildings and infrastructural facilities: 8 Months. 2. Appointment of skilled personnel. 1-2 Months. 3. Purchase of equipments and tools, computers, safety and supervision equipment, kitchen equipment, medical supplies. 1 Month. 4. Purchase of vehicles for transport and conveyance of patients and staff. 1 Month. The total duration for completion of the project is estimated at 9-10 months. The rehabilitation centre is expected to be functional within one year. The expenditure will be sanctioned by the full-time executive administrator authorized by the Board of Directors of the Rehabilitation Center. Part 6: Proposed Budget The total expenditure is expected to be $300000. The sources for funding are: Contributions from the Board of Directors, Government grant, Bank Loan, Donations from community and industrial/business organizations, NGOs and fees from patients under Medicare and Medicaid insurance plans. Recurring expenses will include staff salaries, maintenance costs, insurance and depreciation costs, loan interest, provisions and supplies. Budget Expenditures are estimated as under: 1. Cost of Land, building construction and infrastructure $150000.00 2. Cost of equipments, tools, computers, vehicles, gym equipment $075000.00 Workshop equipment, Transport vehicles, conveyance 3. Cost of mattresses, blankets, bed-sheets, beds, furniture $050000.00 Kitchenware, fittings etc TOTAL INITIAL EXPENDITURE $275000.00 Staff salaries, insurance, maintenance costs (for building, infrastructure, equipments and vehicles), and cost of medical supplies and provisions, depreciation costs, contingency expenditures etc are the major recurring expenditures. The recurring expenditures are estimated at $50000.00 per month. The sourcesof income include fees received from patients’ Medicare/Medicaid insurance, occasional income from community programs and donations. Monthly income from these sources is expected to be more than sufficient to meet recurring expenditure. Part 7: Additional resources needed to resolve the issue Accounting software with financial tracking system will be needed. This software will be installed in computers to monitor different financial transactions and cash-flows during operation. Part 8: Evaluation Methods Evaluation methods are capitalized on proper practice contentions. It is believable that all psychiatric facility staff members ought to take part in intimate assessment of patients on regular basis. They should consider safety standards required for supplies as well as take part in the planning. Additionally, any new measure should be measured to the existing standards. Such initiatives will help improve the general performance in the medical fraternity. The plan should employ implicit strategies in obtaining effective measures. These measures will help cover all the needs of mental disorder patients. Once the plan has been implemented, appropriate action will follow to ensure effective operation (Michigan Health and Safety Coalition, 2002). Part 9: Ethical considerations Tie-ups with Clinics and Hospitals The proposed Psychiatric Rehabilitation Center will enter tie-up arrangements with local clinics and hospitals. The patients, in case of need, will be sent for referrals will be sent for further diagnosis, interventions and in-patient treatments. The center will also integrate with other research institutes for further exploring possibilities for improvements. Training of Healthcare Professionals Training programs will be organized for healthcare professionals and caregivers to keep them updated with latest developments in the psychiatric healthcare. Reputed psychologists, psychiatrists, therapists and dieticians will be invited for lectures. Benefits and Relaxation Facility for Employees Psychiatric healthcare is a challenging occupation. Caregivers and staff feel exhausted (depressed at times) from the duties demanding constant vigil and monitoring of patients. The center proposes to maintain accommodative facilities for employees to regain their composure. Time offs; convenient working hours (in cases of personal emergencies) and incentives will provide motivation to employees. The Aim As T. Meyer et al. (2011, 767) state, the Center will focus on, “… approaches that enhance a person’s health-related quality of life in partnership between person and provider and in appreciation of the person’s perception of his or her position in life.” As mentioned by Anthony and Farkas (2009, 5), state that the name of the model of program, the practitioner, funding and the setting do not matter as much as the, “… people who help people with severe mental illnesses improve their functioning and gain valued roles in the community should be aware of the essentials of the psychiatric rehabilitation process and how to work with it.” The observation reflects the true meaning, essence and message for the Center. In an interview, William Anthony explains the core driving principle and stresses the importance of evidence based practice and the importance of interaction between the mentally disabled/disturbed persons and the practitioners. He states, “The policies and procedures which characterize an evidence-based practice must be complemented by a process that focuses on what happens in the interaction between the people with disabilities and their practitioners.” This observation is vital to understand the process of care-giving to psychiatric patients. The patient and the caregivers are the main stake-holders in the practice of rehabilitation. William Anthony stresses that the caregivers/practitioners should understand the needs of the patients by establishing the rapport and interaction with the patients, to make the program truly effective in helping the disabled persons. Rehabilitation is not a mechanical process and it does not work on equations. Each individual patient poses a challenge for the caregivers and practitioners. The proposed Psychiatric Rehabilitation Center will provide principled leadership and aim at achieving targeted outcomes for the patients. Part 10: cultural Diversities Cultural diversities apply to every group of people. Based on a hospital scenario, there are observable cultural differences between nurses, psychiatrists, and patients. With increased awareness, diverse cultural groups should understand the importance of considering psychiatric rehabilitation centers as an effective practice. Part 11: Business management theories Any management process must involve a team of managers. The balance between utilization of best practices and quality care is difficult and must continually be monitored for improvement of policies and/or procedures. Best practices should lead to the tightest of safety standards, which has a significant reduction in cost(s). Part: 12 Executive Summery This proposal focuses on the current issues facing the medical sector based on psychiatric rehabilitation. In realizing this, the proposal seeks to create a policy manual and implementation issues within the private sector practice. The document mhGAP of WHO discusses ‘The startling gap between effective and available services’ and points out insufficiency of skilled personnel, facilities, budget, policy and programs for rendering effective psychiatric rehabilitation. The goal is to depict issues associated with these areas, especially, under the private sector medical operations for implementation purposes. The issues are discussed in various phases to help find out what is already known, and that which still needs to be established about psychiatry. It incorporates extra resources that are of great importance, evaluation criterion, cultural and ethical considerations. The paper further covers the proposed ways to go about the highlighted issues. The findings will help the physicians to stay in compliance with psychiatric rehabilitation, come up with implementation strategies, and create effective policy manuals. It will also assist the physicians to realize successful implementation and preparation for any looming challenges in psychiatry. The project for the Rehabilitation Center is planned to address the needs of mentally disabled patients during in-patient interventions and after discharge. The key points considered are budget, infrastructure, management, and skilled personnel. References Abelló, D., Fisher, R., and Sitek, T. (2010). Evaluation of the Integrated Rehabilitation and Recovery Care Program. SPRC Report 2/10; Social Policy Research Centre, University of New South Wales. 1-85. www.health.vic.gov.au/mentalhealth/…/rehabilitation_recovery_report.p… Anthony, W. A., and Farkas, M. D. (2009). Primer on the psychiatric rehabilitation process. Boston: Boston University Center for Psychiatric Rehabilitation. 1-49. © 2009, Trustees of Boston University. All rights reserved. Center for Psychiatric Rehabilitation. cpr.bu.edu/wp…/Primer-on-the-Psychiatric-Rehabilitation-Process.pdf .google.co.in/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&uact=8&ved=0CCMQFjAB&url=http%3A%2F%2Fwww.who.int%2Fdisabilities%2Fworld_report%2F2011%2Fchapter4.pdf&ei=IeppVOmQA8XIuAS51oLQAQ&usg=AFQjCNFq2Al0G9oDyvZ7a9w92on7qI1aRw”>Chapter 4 Rehabilitation – World Health Organization: World report on disability 2011. 95-133. www.who.int/disabilities/world_report/2011/chapter4.pdf DaVanzo, J. E. et al (2014). Assessment of Patient Outcomes of Rehabilitative Care Provided in Inpatient Rehabilitation Facilities (IRFs) and After Discharge. FINAL REPORT 13-127 45.Report submitted to ARA Research Institute. © 2014 Dobson DaVanzo & Associates, LLC. All Rights Reserved. .google.co.in/url?sa=t&rct=j&q=&esrc=s&source=web&cd=4&cad=rja&uact=8&ved=0CDUQFjAD&url=http%3A%2F%2Fwww.who.int%2Fmental_health%2Fmedia%2Fen%2F265.pdf&ei=FOZzVM-mAoufuQTaxoL4DQ&usg=AFQjCNFcqw9R_yL8p9srGjVnaWfrJdYcww&sig2=qK2oxTyxIWz4VgkF0co6SQ&bvm=bv.80185997,d.c2E”>Mental Health Global Action Program – World Health… www.who.int/mental_health/media/en/265.pdf T. Meyer et al. (2011). Towards a conceptual description of rehabilitation as a health strategy. J Rehabilitation Med 2011; 43: 765–769. Special Report. www.isprm.org/…/3-Towards-a-conceptual-description-of-rehabilitation-
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