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Evidence to Improve Care

Schizophrenia

Care for Adults in Hospitals

Click below to see a list of brief quality statements and scroll down for more information.


Quality standards are sets of concise statements designed to help health care professionals easily and quickly know what care to provide, based on the best evidence.

See below for the quality statements and click for more detail.


Quality Statement 1: Comprehensive Interprofessional Assessment
Adults who are admitted to an inpatient setting with a primary diagnosis of schizophrenia undergo a comprehensive interprofessional assessment that informs their care plan.


Quality Statement 2: Screening for Substance Use
Adults who present to an emergency department or in an inpatient setting with a primary diagnosis of schizophrenia are assessed for substance use and, if appropriate, offered treatment for concurrent disorders.


Quality Statement 3: Physical Health Assessment
Adults who are admitted to an inpatient setting with a primary diagnosis of schizophrenia undergo a physical health assessment focusing on conditions common in people with schizophrenia. This assessment informs their care plan.


Quality Statement 4: Promoting Physical Activity and Healthy Eating
Adults who are admitted to an inpatient setting with a primary diagnosis of schizophrenia are offered interventions that promote both physical activity and healthy eating.


Quality Statement 5: Promoting Smoking Cessation
Adults who are admitted to an inpatient setting with a primary diagnosis of schizophrenia are offered behavioural and pharmacological interventions to alleviate nicotine-withdrawal symptoms and to help them reduce or stop smoking tobacco.


Quality Statement 6: Treatment With Clozapine
Adults who are admitted to an inpatient setting with a primary diagnosis of schizophrenia who have failed to respond to previous adequate trials of treatment with two antipsychotic medications are offered clozapine.


Quality Statement 7: Treatment With Long-Acting Injectable Antipsychotic Medication
Adults who are admitted to an inpatient setting with a primary diagnosis of schizophrenia are offered the option of a long-acting injectable antipsychotic medication.


Quality Statement 8: Cognitive Behavioural Therapy
Adults who are admitted to an inpatient setting with a primary diagnosis of schizophrenia are offered individual cognitive behavioural therapy for psychosis either in the inpatient setting or as part of a post-discharge care plan.


Quality Statement 9: Family Intervention
Adults who are admitted to an inpatient setting with a primary diagnosis of schizophrenia are offered family intervention.


Quality Statement 10: Follow-Up Appointment After Discharge
Adults with a primary diagnosis of schizophrenia who are discharged from an inpatient setting have a follow-up appointment within 7 days.


Quality Statement 11: Transitions in Care
Adults with a primary diagnosis of schizophrenia who are discharged from an inpatient setting have a team or provider who is accountable for communication and the coordination and delivery of a care plan that is tailored to their needs.

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Physical Health Assessment

Adults who are admitted to an inpatient setting with a primary diagnosis of schizophrenia undergo a physical health assessment focusing on conditions common in people with schizophrenia. This assessment informs their care plan.


Adults with schizophrenia have poorer physical health and a shorter life expectancy than the general population: males with schizophrenia die 20 years earlier and females 15 years earlier. The most common cause of death is cardiovascular disease, which is partly owing to modifiable risk factors such as obesity, smoking, diabetes, hypertension, and dyslipidemia. Antipsychotic medications can be associated with weight gain and can aggravate other metabolic or cardiovascular risk factors. There is a need to comprehensively assess physical health, with a particular emphasis on cardiovascular risk factors and diabetes, to enable treatment if necessary.

For Patients

You should have a physical examination every time you are admitted to hospital. It should focus on conditions that are common in schizophrenia (for example, heart disease and diabetes) and should be used to develop your care plan.


For Clinicians

Complete a physical assessment that focuses on conditions common in people with schizophrenia. The results of these assessments will inform their care plans.


For Health Services

Ensure systems, processes, and resources are in place for health care teams to carry out comprehensive physical health assessments of people with schizophrenia while in the hospital. This includes access to standardized physical assessment protocols and tools.

Process Indicator

Percentage of adults admitted to hospital with a primary diagnosis of schizophrenia who received a comprehensive physical health assessment, including metabolic workup, within the past year

  • Denominator: total number of adults admitted to an inpatient setting with a primary diagnosis of schizophrenia

  • Numerator: number of people in the denominator who received a comprehensive physical health assessment, including metabolic workup, within the past year

  • Data source: local data collection

Percentage of adults admitted to hospital with a primary diagnosis of schizophrenia who did not receive a comprehensive physical health assessment, including metabolic workup, within the past year but receive one during the current hospitalization

  • Denominator: total number of adults admitted to an inpatient setting with a primary diagnosis of schizophrenia who did not receive a comprehensive physical health assessment, including metabolic workup, within the past year

  • Numerator: number of people in the denominator who receive a comprehensive physical health assessment, including metabolic workup, during the current hospitalization

  • Data source: local data collection

Percentage of adults admitted to hospital with a primary diagnosis of schizophrenia who did not receive a comprehensive physical health assessment, including metabolic workup, within the past year but receive one during the current hospitalization

  • Denominator: total number of adults admitted to an inpatient setting with a primary diagnosis of schizophrenia who did not receive a comprehensive physical health assessment, including metabolic workup, within the past year

  • Numerator: number of people in the denominator who receive a comprehensive physical health assessment, including metabolic workup, during the current hospitalization

  • Data source: local data collection

Physical health assessment

This should assess:

  • Weight, body mass index, and waist circumference

  • Pulse and blood pressure

  • Fasting blood glucose or glycosylated hemoglobin (HbA1c)

  • Lipid panel (total cholesterol, low- and high-density lipoproteins, triglycerides)

  • Extrapyramidal signs and symptoms

  • Overall physical health (with particular attention to common findings such as cardiovascular disease and lung disease)

  • Age-appropriate physical health screening

  • Nutritional intake

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