Browsing by Author "Iwamasa, Gayle Y."

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    eHealth Use on Acute Inpatient Mental Health Units: Implementation Processes, Common Practices, and Barriers to Use
    (Springer Nature, 2023) Bass, Emily; Garabrant, Jennifer; Salyers, Michelle P.; Patterson, Scott; Iwamasa, Gayle Y.; McGuire, Alan B.; Psychology, School of Science
    Information technology to promote health (eHealth) is an important and growing area of mental healthcare, yet little is known about the use of patient-facing eHealth in psychiatric inpatient settings. This quality improvement project examined the current practices, barriers, implementation processes, and contextual factors affecting eHealth use across multiple Veteran Health Administration (VHA) acute mental health inpatient units. Staff from units serving both voluntary and involuntary patients (n = 49 from 37 unique sites) completed surveys regarding current, desired, and barriers to use of Veteran-facing eHealth technologies. Two subsets of respondents were then interviewed (high success sites in eHealth use, n = 6; low success sites, n = 4) to better understand the context of their eHealth use. Survey responses indicated that 20% or less of Veterans were using any type of eHealth technology while inpatient. Tablets and video chat were the most desired overall and most successfully used eHealth technologies. However, many sites noted difficulty implementing these technologies (e.g., limited Wi-Fi access). Qualitative analysis of interviews revealed differences in risk/benefit analysis and implementation support between high and low success eHealth sites. Despite desired use, patient-facing eHealth technology is not regularly implemented on inpatient units due to multiple barriers (e.g., limited staffing, infrastructure needs). Successful implementation of patient-facing eHealth may require an internal champion, guidance from external supports with experience in successful eHealth use, workload balance for staff, and an overall perspective shift in the benefits to eHealth technology versus the risks.
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    Recovery-oriented Acute Inpatient Mental Health Care: Operationalization and Measurement
    (American Psychological Association, 2021) McGuire, Alan B.; Kukla, Marina; Rollins, Angela L.; Garabrant, Jennifer; Henry, Nancy; Eliacin, Johanne; Myers, Laura J.; Flanagan, Mindy E.; Hunt, Marcia G.; Iwamasa, Gayle Y.; Bauer, Sarah M.; Carter, Jessica L.; Salyers, Michelle P.; Psychology, School of Science
    Objective: The current article describes efforts to develop and test a measure of recovery-oriented inpatient care. Method: The Recovery-oriented Acute INpatient (RAIN) scale was based on prior literature and current Veterans Health Administration (VHA) policy and resources and further revised based on data collection from 34 VHA acute inpatient units. Results: A final scale of 23, behaviorally anchored items demonstrated a four-factor structure including the following factors: inpatient treatment planning, outpatient treatment planning, group programming, and milieu. While several items require additional revision to address psychometric concerns, the scale demonstrated adequate model fit and was consistent with prior literature on recovery-oriented inpatient care. Conclusions and Implementations for Practice: The RAIN scale represents an important tool for future implementation and empirical study of recovery-oriented inpatient care.
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    Recovery-oriented inpatient mental health care and readmission
    (American Psychological Association, 2022) McGuire, Alan B.; Flanagan, Mindy E.; Myers, Laura J.; Kukla, Marina; Rollins, Angela L.; Garabrant, Jennifer; Henry, Nancy; Eliacin, Johanne; Hunt, Marcia G.; Iwamasa, Gayle Y.; Carter, Jessica L.; Salyers, Michelle P.; Psychology, School of Science
    Objective: This article examines the relationship between inpatient mental health units' adherence to recovery-oriented care and 30-day patient readmission. Method: The sample included patients admitted to one of 34 Veterans Health Administration inpatient mental health units. Recovery-oriented care was assessed using interviews and site visits. Patient characteristics and readmission data were derived from administrative data. Findings: Overall recovery orientation was not associated with readmission. Exploratory analyses found higher scores on a subsample of items pertaining to inpatient therapeutic programming were associated with lower patient readmissions. Additionally, patients with more prior service use and substance abuse or personality disorders were more likely to be readmitted. Conclusions and implications for practice: A growing body of literature supports the association between psychotherapeutic services in inpatient units and better patient outcomes. However, further research is needed to examine this association. More work is needed to develop appropriate psychotherapy services for the inpatient setting and support their implementation.