scholarly journals Facilitated early discharge in Wandsworth

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S115-S115
Author(s):  
Mudasir Firdosi ◽  
Allerdiena Hubbeling ◽  
Twaisha Kapoor
Keyword(s):  
Treatment Duration ◽  
Severity Of Illness ◽  
Early Discharge ◽  
Home Treatment ◽  
Electronic Records ◽  
Future Research ◽  
Treatment Team ◽  
National Scale ◽  
Psychiatric Admissions ◽  
Total Treatment

ObjectiveThere is limited research surrounding facilitated early discharge (FD) and Home Treatment Teams (HTTs). This study aimed to compare patients who received FD with patients who were discharged without FD to identify whether there were significant differences in terms of social demographics, illness characteristics, health outcome and treatment duration. Using this data we furthermore aimed to provide proposals to help advance the effectiveness of FD, as well as suggesting concepts of where future research should lie.Case reportA randomised sample of patients who received FD and patients who were discharged without FD was obtained from a South London Hospital. This was manually narrowed down to patients specifically treated by the Wandsworth Home Treatment Team (WHTT). Socio-demographic and clinical data were then attained from the patients’ electronic records to compare and statistically analyse between the two groups.DiscussionPatients who received FD from the WHTT were found to have significantly less previous psychiatric admissions compared to those who were discharged without FD (p = 0.032). All other variables were found to have no association with FD.ConclusionHaving a high number of previous psychiatric admissions seems to be an aspect that decreases the chance of being allocated FD. This variable can be seen as an indicator of severity of illness and a challenging social environment; it could therefore be valuable to take this variable into consideration when allocating FD. Furthermore, total treatment duration was found to not be significantly different for FD and non-FD patients, thus supporting the use of CRHTTs as an equivalent alternative for inpatient admission, however, national scale research should be conducted to strengthen and expand on these findings.

scholarly journals Improving quality and assessment of referrals to the Enfield Crisis Resolution and Home Treatment Team (ECRHTT)

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S202-S202
Author(s):  
Margarita Kousteni ◽  
John Cousins ◽  
Ajay Mansingh ◽  
Maja Elia ◽  
Yumnah Ras ◽  
...  
Keyword(s):  
Home Treatment ◽  
Absolute Difference ◽  
List Type ◽  
Treatment Team ◽  
Crisis Resolution ◽  
Post Intervention ◽  
Improvement Project ◽  
Consultant Psychiatrist ◽  
The Impact

AimsTriaging referrals to crisis resolution and home treatment teams is a significant undertaking requiring experienced and dedicated staff. We observed that the volume of inappropriate referrals to ECRHTT was high, and that staff processing these often felt inexperienced or lacking in confidence to discharge them back to the referrers and signpost them to appropriate services.The aims of this quality improvement project (QIP) were: a)to reduce the number of inappropriate referrals received by the teamb)to reduce the number of inappropriate referrals accepted by the teamThis would significantly improve access and flow to the service and facilitate better patient care.MethodA pilot study was first completed of the quality (appropriateness/ inappropriateness) and source of all referrals to ECRHTT in January 2019 (n = 177).Subsequently, the consultant psychiatrist for ECRHTT based himself within the assessment team. He was able to closely monitor the referrals, at the same time as providing medical input to patients at their first point of contact. To evaluate the impact of this intervention, the percentage of inappropriate referrals accepted pre- and post-change was compared by re-auditing all referrals received in February 2019 (n = 175).Further interventions were instigated to improve referral quality. These included continuation of psychiatric medical input to the assessment team, teaching sessions for GPs and the crisis telephone service, and weekly meetings with psychiatric liaison and community mental health teams (CMHTs). Change was measured by reassessing the quality of all referrals made to ECRHTT in February 2020 (n = 215).Result46.9% of inappropriate referrals to ECRHTT were accepted in January 2019 compared to 16.9% in February 2019 following the addition of medical input to the assessment team. The absolute difference was 30% (95% CI: 14%–44%, p < 0.001).71% of referrals from GPs were inappropriate in January 2019 compared to 36% in February 2020 post-intervention (difference 35%, 95% CI: 8.84%–55.4%, p < 0.05). Inappropriate referrals from CMHTs decreased from 55.5% to 12% (difference 43.5%, 95% CI: 9.5%–70.3%, p < 0.05). Overall, the percentage of inappropriate referrals fell from 38% to 27.4%, a difference of 10.6% (95% CI: 1.3%–19.8%, p < 0.05). The percentage of inappropriate referrals from liaison teams did not change significantly.ConclusionThis piece of work shows that better engagement with referral sources significantly improved the quality of referrals made to ECRHTT. Interventions included medical input at the point of referral, teaching sessions for general practitioners as well as ongoing liaison with referring teams.

scholarly journals Adjunctive surgery after total arch distalization to optimize esthetics

2020 ◽  
Vol 10 ◽  
pp. 185-190
Author(s):  
Ahmad Abdulwhab ◽  
Ja Hyeong Ku ◽  
Fawaz Alfawaz ◽  
Jae Hyun Park ◽  
Yoon-Ah Kook
Keyword(s):  
Case Report ◽  
Adult Patient ◽  
Treatment Duration ◽  
Orthodontic Treatment ◽  
Mandibular Arch ◽  
Palatal Plate ◽  
Total Treatment ◽  
Maxillary Arch

This case report presents surgically assisted orthodontic treatment for an adult patient due to labial exostosis, prominent malar, and unesthetic chin. Her treatment was total arch distalization with modified C-palatal plate for maxillary arch and miniscrews for mandibular arch. In addition, she was treated with alveoloplasty, malarplasty, and genioplasty to improve the consistency of her profile. The total treatment duration was 28 months.

P.1.k.029 Predictors of acute psychiatry hospitalisation from a home treatment team

2015 ◽  
Vol 25 ◽  
pp. S369
Author(s):  
V. Chavarría Romero ◽  
M. Llobet ◽  
A. Malagon ◽  
M. Bellsola ◽  
A. Gonzalez ◽  
...  
Keyword(s):  
Home Treatment ◽  
Treatment Team ◽  
Acute Psychiatry

Electronic Records Management - An Old Solution to a New Problem

Big Data ◽  
2016 ◽  
pp. 2249-2274
Author(s):  
Chinh Nguyen ◽  
Rosemary Stockdale ◽  
Helana Scheepers ◽  
Jason Sargent
Keyword(s):  
Big Data ◽  
Rapid Development ◽  
Large Data ◽  
Large Data Sets ◽  
Electronic Records ◽  
Future Research ◽  
Records Management ◽  
Data Sets ◽  
Interactive Nature ◽  
Electronic Records Management

The rapid development of technology and interactive nature of Government 2.0 (Gov 2.0) is generating large data sets for Government, resulting in a struggle to control, manage, and extract the right information. Therefore, research into these large data sets (termed Big Data) has become necessary. Governments are now spending significant finances on storing and processing vast amounts of information because of the huge proliferation and complexity of Big Data and a lack of effective records management. On the other hand, there is a method called Electronic Records Management (ERM), for controlling and governing the important data of an organisation. This paper investigates the challenges identified from reviewing the literature for Gov 2.0, Big Data, and ERM in order to develop a better understanding of the application of ERM to Big Data to extract useable information in the context of Gov 2.0. The paper suggests that a key building block in providing useable information to stakeholders could potentially be ERM with its well established governance policies. A framework is constructed to illustrate how ERM can play a role in the context of Gov 2.0. Future research is necessary to address the specific constraints and expectations placed on governments in terms of data retention and use.

Nanotechnology for Filtration-Based Point-of-Use Water Treatment

2016 ◽  
pp. 27-49
Author(s):  
Kathryn Gwenyth Nunnelley ◽  
James A Smith
Keyword(s):  
Water Treatment ◽  
Home Treatment ◽  
New Method ◽  
Future Research ◽  
Point Of Use ◽  
New Development ◽  
Treatment Technologies ◽  
Infrastructure Investments ◽  
Filter Papers ◽  
Antimicrobial Effectiveness

With significant infrastructure investments required for centralized water treatment, in home treatment technologies, known as point-of-use, have become a popular solution in the developing world. This review discusses current filtration-based point-of-use water treatment technologies in three major categories: ceramics, papers and textiles. Each of these categories has used silver for added antimicrobial effectiveness. Ceramics have had the most development and market infiltration, while filter papers are a new development. Textiles show promise for future research as a cheap, socially acceptable, and effective method. Also, a new method of silver incorporation in ceramics is explored.

scholarly journals Intensive home treatment, admission rates and use of mental health legislation

2010 ◽  
Vol 34 (12) ◽  
pp. 522-524 ◽  
Author(s):  
Naida F. Forbes ◽  
Helen T. Cash ◽  
Stephen M. Lawrie
Keyword(s):  
Mental Health ◽  
Home Treatment ◽  
Treatment Team ◽  
Admission Rates ◽  
Duration Of Hospital Stay ◽  
Mental Health Legislation ◽  
Local Impact ◽  
Health Legislation ◽  
Least Restrictive Alternative ◽  
Alternative Principle

Aims and methodWe examined the local impact of introducing a home treatment team on the use of in-patient psychiatric resources and rates of detention under the Mental Health (Care and Treatment) (Scotland) Act 2003.ResultsRates of admission to hospital and duration of hospital stay were unchanged. However, there was an increase in episodes of detention in the year following the team's introduction.Clinical implicationsOffering home treatment as an alternative to in-patient care may be associated with an increase in compulsory treatment. If true, this is incompatible with the ‘least restrictive alternative’ principle of the recently revised mental health legislation.

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