VA inpatient psychiatric hospitals fall short on quality measures

For veterans and others entering inpatient psychiatric care, an admissions screening can be key to identifying the most appropriate treatment. But a new study by researchers from Harvard T.H. Chan School of Public Health finds that hospitals run by the U.S. Department of Veteran’s Affairs (VA) are failing to ask patients important questions about their trauma history, substance use, violence risk, and strengths (such as optimism and stable employment) 39 percent of the time, on average. By comparison, the study found that for-profit and nonprofit hospitals conduct such screenings nearly all of the time.

The researchers also found that the VA is falling short on other quality measures. For example, they found the VA failed to provide appropriate justification for discharging patients on multiple antipsychotics 61 percent of the time, and created a continuing care plan for patients upon discharge just about half of the time.

The study was published online Oct. 17, 2016 in Psychiatric Services.

“These results are very troubling,” said lead author Morgan Shields, S.M. ’16. “They further substantiate the need for VA hospitals to receive greater regulation and financial resources.” Shields, now a doctoral student at the Heller School for Social Policy and Management at Brandeis University, conducted the research while a student at Harvard Chan School.

She and co-author Meredith Rosenthal, professor of health economics and policy, looked at how well VA, for-profit, and nonprofit hospitals perform on seven quality measures for inpatient psychiatric care. According to Shields, researchers and policymakers need more data to improve the mental health care system