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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.

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.


Clozapine has been demonstrated to be highly effective and is the treatment of choice if someone with schizophrenia has a partial or total nonresponse to other antipsychotic treatments.

For Patients

If you have tried at least two different antipsychotic medications and your symptoms have not improved, you should be offered clozapine. Clozapine is taken orally.


For Clinicians

Offer people with schizophrenia clozapine if they have tried two antipsychotic medications without success.


For Health Services

Through adequately resourced systems and services, ensure that clinicians are able to offer clozapine as a treatment for people with schizophrenia who are admitted to hospital.

Process Indicator

Percentage of adults admitted to hospital with a primary diagnosis of schizophrenia who have not responded adequately to treatment with at least two antipsychotic medications and who are offered clozapine

  • Denominator: total number of adults admitted to an inpatient setting with a primary diagnosis of schizophrenia who have not responded adequately to treatment with at least two antipsychotic medications

  • Numerator: number of people in the denominator who are offered clozapine while in hospital

  • Data source: local data collection

Percentage of adults admitted to hospital with a primary diagnosis of schizophrenia who did not respond adequately to treatment with at least two antipsychotic medications, and who receive clozapine

  • Denominator: total number of adults admitted to an inpatient setting with a primary diagnosis of schizophrenia who did not respond adequately to treatment with at least two antipsychotic medications and who were offered clozapine

  • Numerator: number of people in the denominator who receive clozapine while in hospital

  • Data source: local data collection

Failure to respond

This refers to schizophrenia that has not improved despite adequate dosages and durations of two antipsychotic medication trials, with reasonable assurance of medication adherence during the trials. The trials may or may not have been initiated within an inpatient setting.

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