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Beyond the Door: Mapping Patient Experiences in an Open-door Inpatient Psychiatric Unit

Cuevas-Esteban, J.; Ruiz-Garros, E.; Romero-Diaz, E.; Motta-Rojas, N.; Jimenez-Fernandez, B.; Fernandez-Ribas, A.; Martinez-Cirera, B.; Moreno-Orea, A.; Miro-Mezquita, L.

2025-10-02 psychiatry and clinical psychology
10.1101/2025.10.01.25337052 medRxiv
Show abstract

Open-door policies in inpatient psychiatric care have been increasingly adopted to enhance patient autonomy and reduce coercive practices. However, systematic methodologies for evaluating patient experiences in these settings remain limited. This study applies Patient Journey Mapping within an open-door acute psychiatric unit, to comprehensively analyze the hospitalization experience. Using a mixed-methods approach, qualitative data were first collected via focus groups (n=18), adhering GRAMMS guidelines, to identify critical touchpoints, and then quantitative data (n=32) were gathered through an adapted Likert-type ordinal scale to assess patient satisfaction. Data were analyzed using content analysis methodology. Results delineate key hospitalization phases and identify "Moments of Truth," "Moments of Pain," and "Wow Moments," which significantly shape patients perceptions of care quality. While open-door policies promote autonomy and reduce psychological distress, challenges persist in admission processes, medication administration privacy, and communication regarding structured activities. These findings highlight the need for patient-centered methodologies in psychiatric care to optimize service delivery, foster therapeutic environments, and enhance recovery-oriented practices.

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