Ensuring High Quality Oyster Care for People Experiencing Severe and Persistent Mental Illness – A Three-Phase Development of A Quality Monitoring Tool

Oyster Care is an innovative care model designed to meet the needs of people experiencing severe and persistent mental illness. A population often overlooked within healthcare systems and at heightened risk when care becomes either ineffective or prematurely discontinued. In recent years, the adoption of Oyster Care principles has gained attention within Flemish mental health care. Consequently, there is growing recognition of the need for a tool that supports the consistent implementation of Oyster Care model and provides caregivers with clear, actionable guidance to improve care quality. A mixed-methods study was conducted between 2021 and 2023 within Flemish residential mental health care services. The study consisted of three sequential phases. In the first phase, a literature review and qualitative research were undertaken to identify and explore the core principles of the Oyster Care model. In the second phase, these principles were translated into operational indicators and validated through a Delphi expert consensus process. In the final phase, experts prioritized and selected the most relevant indicators for inclusion in the Oyster Care monitor. The monitor consists of 79 indicators of high-quality Oyster Care. These indicators are grouped into 24 sub-themes, and organized under eight overarching themes: The care process; The somatic pillar; The psychological pillar; The social pillar; The existential pillar; End-of-life care; Team vision, culture, and development; The living environment. The SCV-I demonstrated 97% for clarity and 93% for relevance. The monitor enables teams to assess and guide the implementation of the Oyster Care model within their own practice. By systematically evaluating care practices, teams can gain objective insights into their performance and identify areas for improvement. The monitor is both theoretically sound and practice-based, adapted to the specific imperatives of Oyster Care and applicable in the real context of residential mental health care in Flanders.