Patient-Oriented Administration In a Day Hospital

A dministration Hospitala DayRAQUEL E.COHEN,M.D.Staff Visit MassachusettsTins is A PRELIMINARY ATrEMPT to present of psychiatric administration, based on the the establishment and day-to-day functioning peutic environment” should be at the level In_v ractions between the patients team carrying all the administrative is in contrast to the classical anda novel plan premise that of a “theraof individualthe members of a responsibility. This administrative methodwherein the staff members’ reports to the chief of service constitute his only source of intimate knowledge about the patient. It is also in contrast to services where teaching is one of the main functions and each medical resident is responsible for some administration. The administrative structure described herein was established in the day-hospital unit of the Massachusetts Mental Health Center at a time when the unit was semiautonomous and only partially integrated with the general teaching and training plan for the center. The concentration of all administration in the chief of service was carried out by a division of responsibilities. Patients were assigned to second-year residents, who were responsible for psychotherapy. The chief of service handled all matters pertaining to daily living problems in the hospital. There are notable differences between the orthodox twenty-four-hour care unit and the day-hospital service. The two areas of greatest difference are in the role of the psychiatric nurse and in the characteristics of the patients as a functioning group.The nurse’s role is much more clearly defined in the day hospital than it is in the usual full-hospitalization setting. The schedule allows...