The effective management of change is fostered by establishing the objectives that need to be met to facilitate the effectiveness and coordination of activities between the stakeholders that are affected by the change. The aims of the project include:
• To facilitate person-centred treatment
• To ensure adequate care is available for those who are critically ill in through in-patient care
• To reduce the cost of inpatient care
The specific objectives that will be met by the HBTT model of treatment include:
• To ensure there is a decline in the total number of inappropriate admissions to inpatient units, subsequently enhancing the quality of healthcare to the patients who need admission.
• To streamline access to psychiatric services where admission is likely to be done while increasing efficiency in personalized care services.
• Increase the availability of out-of-hours communal psychiatric services at the time of need.
Despite the increased advocacy and shift to community-based mental care delivery in the last three decades, the in-patient treatment model remains a challenge regarding the cost in organisations that offer integrated services. Insights from Burns et al. (2001) show that the challenge experienced due to the expenses incurred in in-patient care is a key impediment to the expansion of mental health care provisions in the community. Despite this, there are a variety of models of community services that have been implemented. Their subsequent success shows that home-based care can be effective and a solution to the high costs of in-patient treatment. The HBTT alludes to crisis resolution and home treatment medical personnel, who are focused on offering rapid assessment for mental health patients and where possible to administer intensive home treatment instead of acute admission in the psychiatric hospital (Uddin, 2006).
The services that offered by the HBTT will be aimed at clients between the age of 16 and 65 years. Also, persons over the age of 65 years who experience functional illnesses that include depression, anxiety, severe agitation, and those who have extreme mental health conditions, that without the engagement of HBTT, hospitalization will be required. Nevertheless, there are many and varied crises that warrant the involvement of HBTT. These conditions include a breakdown in the normal coping abilities of a patient, a substantial deterioration in the mood of an individual coupled with suicidal thoughts, a detrimental change in psychotic symptoms, and reduced social performance or social withdrawal (which may be seen in depression, simple type of schizophrenia, etc.) among other conditions. The crisis can be experienced as developmental symptoms among patients who already have mental health issues. Additionally, they might be triggered by certain experiences in the individual’s daily life. For instance, the loss of a job can trigger suicidal thoughts. Different risk factors can warrant the patient being seen within 24 hours. With the adoption of an effective operation model, the HBTT can offer rapid assessment and a variety of psychotherapeutic solutions as a substitute for inpatient care.
The proposed operation model for the HBTT involves a strategic approach that involves the cooperation of the medical personnel, management, patients, and their relatives. The coordinator of the HBTT will be required to discuss if the referral made is appropriate for the parties who refer the patient (National Vision for Change Working Group, 2012). During this engagement, the actual and potential risks are discussed via phone and approximations on when the patient might be seen will be communicated (Johnson, 2013). The HBTT personnel will have 24 hours from the time the referral is made within which they can offer services to the patient. Once the coordinator accepts the referral, a team is assigned to the patient for assessment to be made. Determining the appropriateness of the patient to engage in the HBTT model of treatment or being referred to inpatient treatment can be facilitated using various tools that include an assessment by completing various questionnaires (Uddin, 2006). The HBTT will offer the clients leaflets that will highlight the team’s expectations and limitations to ensure that the people are aware of their effectiveness in different situations. After the engagement with the patient, the HBTT will discuss the patient at the next possible meeting in the office to formulate the next step in treatment based on the emerging factors.
The period of treatment can last between a day to about six weeks. The period of treatment is determined by the needs and the circumstances under which the referral is made to the HBTT. A period of open contact can be offered, which is the time a patient or family member can contact the team if the patient experiences any form of deterioration in their mental condition. The undertakings of the HBTT personnel that includes the assessments and treatments offered must be well documented. Also, the feedback from the patients should be gathered to identify the complaints, the effectiveness of the treatment provided, details of progress, details of medication, and any arrangements made after discharge with the HBTT personnel. After all the paperwork is completed, it will be filed for archiving. In this context, paperwork can be used, or alternative technologies can be used to integrate the change to other developments in the medical field, such as the use of electronic health records. In cases where the patient experiences acute conditions that cannot be maintained in the home setting, the recommendation will be made for the appropriate time they should stay in the hospital and then the HBTT approach can be reinstalled as a follow-up procedure (Uddin, 2006). In this context, the organisation is required to establish a link worker post that will facilitate the integration of HBTT activities with inpatient care. The link worker will be responsible in supporting the hospitalized patients in in-patient care and engage in planning the discharge of the individual once their mental health is appropriate for home-based care and the subsequent transition to HBTT care. The consideration is appropriate for the patient to retain the same personalized care with the key health workers and facilitate continuity of care that focuses on the client rather than the systems. On the same note, once patients are discharged from the health centre, the HBTT personnel will engage in follow-up interventions for further-two weeks to ensure the sustainability and quality of care and reduce the number of readmissions, which further increases the costs incurred by the organisation.