scholarly journals The Safety Conversation: developing a trustwide safety conference at CNWL during a pandemic

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S133-S134
Author(s):  
Emily Duncan ◽  
Simon Edwards ◽  
Alison Butler ◽  
Cornelius Kelly
Keyword(s):  
Quality Improvement ◽  
Open Space ◽  
Community Health Services ◽  
Good Representation ◽  
List Type ◽  
Frontline Staff ◽  
New Ways Of Working ◽  
Use Of Technology ◽  
Virtual Conference ◽  
Strongly Agree

AimsThe COVID pandemic has had both a massive impact on clinical service delivery and the way that training and education is provided. CNWL is a large NHS provider and has approximately 7000 staff working across 150 locations, providing mental health and community health services. In response to the need to share learning across the organisation, a trustwide “Safety Conversation Day” took place to spotlight the work being done to promote safety and to act as a platform to share ideas and learning across the trust. This was the first ever virtual conference organised by the trust.MethodThe one-day conference included virtual posters and an all-day open access virtual conversation delivered via zoom. The day was divided into 6 safety themes: Safety tools; Safer Environments; Supporting and Involving Staff; Safer use of Medicines; See Think Act and Relational Security; and Prevention is Better than Cure. Frontline staff delivered 5-6 short presentations each hour highlighting new ways of working, quality improvement, local research etc.Staff were also encouraged to submit posters for the event, with webinars held on how to write a poster held prior to the safety conversation to promote engagement. Prizes were awarded for best posters in the different categories.A mentimeter survey was running throughout the day to get feedback from participants.ResultThis was the largest event of this kind held by the trust. 430 unique viewers logged in during the day to watch the presentations.Feedback was very positive on the mentimeter survey. 3 questions were asked on a likert scale of: Strongly Disagree – Strongly Agree (rated out of 5): –‘I found the posters really useful': 4.5/5–‘I found the presentations very useful': 4.6/5–‘I will share what I've learnt about safety': 4.6/5Open space questions and word cloud responses also highlighted qualitative feedback with most frequent responses including ‘inspiring', ‘interesting and ‘stimulating’.174 posters were presented with good representation from all services and staff groups across the trust (18 on safer use of medicines, 15 on co-production, 52 on quality improvement, 50 on COVID and non-COVID safety, 16 on use of technology, 23 on supporting and involving staff). These posters have since been downloaded 4062 times.ConclusionThe first CNWL safety conference proved an excellent opportunity to celebrate achievements in patient safety in a very difficult year. It was very well-received and well-attended by staff, promoting maximal learning across the organisation.

scholarly journals Quality improvement project: delirium awareness and training in coventry memory services

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S229-S229
Author(s):  
Nurul Yahya ◽  
Karim Saad
Keyword(s):  
Quality Improvement ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Basic Knowledge ◽  
List Type ◽  
Nice Guidelines ◽  
Memory Assessment ◽  
Confusion Assessment ◽  
Brief Training ◽  
Strongly Agree

AimsBy way of Quality Improvement, this project aims to identify awareness levels, deliver a brief training and thus increasing the confidence of Memory Assessment Clinicians in detecting delirium.BackgroundPeople with dementia are at greater risk of delirium, and the acute confusion associated with delirium may be mistaken as part of their dementia. Despite having an estimated prevalence in care homes of 14.2% in the UK, delirium is under-recognised. Memory Assessment Clinicians may have low confidence in identifying and have low awareness of delirium despite being tasked with a triage and diagnostic role in dementia assessment. NICE has recently updated the guidelines on Delirium in March 2019 with recommendations on prevention and treatment of Delirium.MethodWe delivered a survey pertaining: (a)Awareness of Delirium NICE Guidelines(b)Confidence in spotting DeliriumWe used convenience sample of Memory Assessment Clinicians in Coventry. Overall, this survey was uptake by 17 clinicians. The pre training survey was done in early October 2019 and the post training survey was done shortly after the training, at the end of October 2019.A brief training comprising NICE Guidelines and using Confusion Assessment Method (CAM) was delivered. The survey is repeated post training and differences in result of level of confidence is done to measure changes. The survey assessed knowledge, beliefs, practices and confidence level regarding delirium detection.ResultPre training:17 clinicians took part in the survey. 59% was aware that there is a delirium NICE guidelines. 12% felt strongly agree, 41% agree and 47% felt neutral in their confidence of detecting delirium.Post training:10 clinicians took part in the survey. 50% felt strongly agree and 50% agree that they are confident in detecting delirium.Overall, the mean difference is 2 and the p value is 0.92034. we used Mann- Whitney Test to measure the difference in pre and post training which showed not significant at p < 0.05.Participants felt that the training was useful and relevant to practice.ConclusionThis study showed our clinicians have a good basic knowledge in detecting delirium. As a result of this study, we have created ‘Delirium checklist’ and Confusion Assessment Method (CAM) to be used during duty work. We also feel that the majority of delirium cases referred to us comes from the community base, thus our next step of the project will be to involve educational work with the community care home.

Integrated care: learning from East London

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697265
Author(s):  
Sonia Bussu
Keyword(s):  
Integrated Care ◽  
Evidence Base ◽  
Community Health Services ◽  
Health Economy ◽  
Local Health ◽  
Frontline Staff ◽  
Care Community ◽  
Organisation Development ◽  
Integrated Care Pathways ◽  
Local Health System

BackgroundDespite a growing body of literature on integrated, there remains a relatively small evidence base to suggest which elements of integrated care are most effective and how to implement them successfully. This might also be due to the fact that policy thinking around integrated care is struggling to translate into organisation change at the point of delivery. Better understanding of patterns of collaborations and integrated pathways is crucial to understand frontline staff’s OD needs and provide adequate support.AimThis paper focuses on the frontline level to assess progress towards integrated care in East London.MethodWe use admission avoidance (Rapid Response service) and discharge services (Discharge to Assess) as a lens to examine how frontline staff from secondary care, community health services and social service work together to deliver more integrated care. The study uses the Researcher in Residence (RiR), where the researcher is embedded in the in the organisations she is evaluating, as a key member of the delivery team.ResultsInitial findings suggest that while work on integrated care has enabled some level of collaborative working at strategic levels in partner organisations, on the frontline professionals are grappling with issues such as professional identity, professional boundaries, mutual trust and accountability, as new services and roles struggle to be fully embedded within the local health system.ConclusionThe paper sheds light on to the complexity on integrated care at the point of delivery. Better understanding of integrated care pathways is crucial to evidence patterns of collaboration across organisations; assess how these new roles and teams are embedding themselves within the local health economy; identify organisation development needs; and provide adequate support to frontline staff.

scholarly journals Psychosexual history-taking in the 21st century: new terminology, new technology and new risks

2018 ◽  
Vol 25 (3) ◽  
pp. 166-176
Author(s):  
Lisa Gardiner
Keyword(s):  
Social Media ◽  
Sexual Offending ◽  
Psychiatric Patients ◽  
New Technology ◽  
Relationship Maintenance ◽  
The Internet ◽  
List Type ◽  
History Taking ◽  
Sexual Behaviours ◽  
Use Of Technology

SUMMARYSexual and relationships difficulties are not uncommon among psychiatric patients. A presenting complaint of anxiety or depression may relate to an underlying sexual or relationship difficulty; commonly used psychotropic medications cause sexual side-effects that can have a significant impact quality of life, relationship maintenance and treatment adherence; patients may exhibit unusual or excessive sexual behaviours when acutely unwell, including risky use of apps to meet sexual partners and accessing online pornography in unsafe ways; patients may have used technology such as the internet to harm others or they may be victims of such harm; the internet and social media might even be influencing sexual expression, for example gender identity. Therefore, psychosexual history-taking remains a key competency for psychiatrists. They must also understand the new language used to describe sexuality, sexual behaviours and the use of social media, apps and so on to form relationships. This article outlines the key areas to consider in carrying out a structured psychosexual assessment. It also gives an overview of current sexual terminology, observed influences of the internet on sexuality and sexual behaviour, and its implications for mental health and potential sexual offending.LEARNING OBJECTIVESAfter reading this article you will be able to: •outline a framework for psychosexual history-taking•recognise emerging terminology relating to sexual behaviours and identity•understand the relevance of the internet, social media and technology-based apps to human relationships, including the use of technology in sexual offendingDECLARATION OF INTERESTNone.

scholarly journals A series of five population-specific Indian brain templates and atlases spanning ages 6 to 60 years

2020 ◽  
Author(s):  
Bharath Holla ◽  
Paul A. Taylor ◽  
Daniel R. Glen ◽  
John A. Lee ◽  
Nilakshi Vaidya ◽  
...  
Keyword(s):  
Brain Morphology ◽  
Good Representation ◽  
List Type ◽  
Spatial Normalization ◽  
Maximum Probability ◽  
Total N ◽  
Brain Scans ◽  
Native Space ◽  
Probability Map ◽  
Population Average

AbstractAnatomical brain templates are commonly used as references in neurological MRI studies, for bringing data into a common space for group-level statistics and coordinate reporting. Given the inherent variability in brain morphology across age and geography, it is important to have templates that are as representative as possible for both age and population. A representative-template increases the accuracy of alignment, decreases distortions as well as potential biases in final coordinate reports. In this study, we developed and validated a new set of T1w Indian brain templates (IBT) from a large number of brain scans (total n=466) acquired across different locations and multiple 3T MRI scanners in India. A new tool in AFNI, make_template_dask.py, was created to efficiently make five age-specific IBTs (ages 6-60 years) as well as maximum probability map (MPM) atlases for each template; for each age-group’s template-atlas pair, there is both a “population-average” and a “typical” version. Validation experiments on an independent Indian structural and functional-MRI dataset show the appropriateness of IBTs for spatial normalization of Indian brains. The results indicate significant structural differences when comparing the IBTs and MNI template, with these differences being maximal along the Anterior-Posterior and Inferior-Superior axes, but minimal Left-Right. For each age-group, the MPM brain atlases provide reasonably good representation of the native-space volumes in the IBT space, except in a few regions with high inter-subject variability. These findings provide evidence to support the use of age and population-specific templates in human brain mapping studies. This dataset is made publicly available (https://hollabharath.github.io/IndiaBrainTemplates).HighlightsA new set of age-specific T1w Indian brain templates for ages 6-60 yr are developed and validated.A new AFNI tool, make_template_dask.py, for the creation of group-based templates.Maximum probability map atlases are also provided for each template.Results indicate the appropriateness of Indian templates for spatial normalization of Indian brains

scholarly journals Research on the impact of artificial intelligence on the business model of an organization

E-Management ◽  
2021 ◽  
Vol 3 (4) ◽  
pp. 26-36
Author(s):  
A. A. Dashkov ◽  
Yu. O. Nesterova
Keyword(s):  
Artificial Intelligence ◽  
Information And Communication Technologies ◽  
Business Model ◽  
Digital Transformation ◽  
Successful Implementation ◽  
New Ways Of Working ◽  
Use Of Technology ◽  
Physical Assets ◽  
The Moment ◽  
The Impact

The digital transformation of our world and the inevitable interaction between people, digital technologies and physical assets create a rapidly changing and complex environment that requires organizations to be more flexible, better fit and ready to accept new ways of working. Businesses are coming to realize the need for change to operate successfully in the digital age. In the period of global digitalization, information and communication technologies are one of the most important aspects of existence for a business, which makes it more efficient, efficient and allows you to respond quickly to a rapidly changing external environment, as well as customer needs. At the moment, there is a high interest in the possibilities of artificial intelligence for use in business tasks in the world, as there are already examples of successful implementation, when Artificial Intelligence and machine learning radically change the way they work and increase the profit of organizations in different countries.The purpose of this study is to consider how artificial intelligence affects the value proposition and how the elements of the business model change when using this technology. The paper gives the existing examples of the use of technology, the consequences of its application and the emerging prospects for the use of Artificial Intelligence as one of the advanced technologies of digital transformation.

scholarly journals A community service review of the quality of inpatient discharge summaries from six inpatient wards at St Charles Hospital: an initial audit and quality improvement recommendations

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S205-S205
Author(s):  
Omar Mahmoud ◽  
Jasna Munjiza ◽  
Jacob King
Keyword(s):  
Mental Health ◽  
Quality Improvement ◽  
Community Mental Health ◽  
Legal Status ◽  
Bimodal Distribution ◽  
Admission Diagnosis ◽  
List Type ◽  
Convenience Sample ◽  
Reason For Admission ◽  
Discharge Summaries

AimsTo discuss whether Discharge summaries include important information to community mental health teams .To identify patterns and produce recommendations for change by Quality improvement methods .MethodA convenience sample was selected of the first 5 patient discharges from each of the 6 adult inpatient wards at St Charles Hospital. This represented a total of 30 reviewed summaries. Outcome items were generated following discussion with community psychiatric colleagues based on those aspects of an admission thought to be of most use to a community mental health team. These were; reason for admission, diagnosis, circumstances of admission, progress on the ward, risk assessment, physical health, legal status on discharge, discharge medication, discharge management plan, contact details. Basic identification was also recorded as was the ward and date of dischargeResult•Only 3.3% (1/30) of discharge summaries were complete of all items.•However 23.3% (7/30) were almost complete, failing to record only a single item, and a further 2 missing only 2 of 10 items. There was a bimodal distribution (Graph 1).•Seven (7/30) discharge summaries provided no information. Of these, four (4/7) discharge summaries were written in the progress notes directly, rather than using the discharge summary proforma.•The ‘reason for admission’ item was a clear low outlier with only 2/30 reporting this piece of information. For a number of cases, this was recorded unhelpfully as “in crisis”.ConclusionThere was limited evidence of systemic patterns,however some wards showed internal stark differences with some summaries complete or almost complete and others empty.The key findings from this report are the high number of discharge summaries which have either no responses to them (7/30). This may indicate that the writer did not know how to use the current discharge template, and therefore support with using this is indicated. For those with a very low (7/30) number of item responses, we might conclude that these discharge summaries were written by someone with knowledge of using the system, but for another reason did not complete the majority of the items asked, and for this reasons are not immediately clear. Similarly, as highlighted above the main low outlying result relates to the apparent widespread practise of writing “in crisis” as the ‘reason for admission’, unfortunately to community teams this is an unhelpful and self-evident response.

scholarly journals Adaptation of a nursing home culture change research instrument for frontline staff quality improvement use.

2017 ◽  
Vol 14 (3) ◽  
pp. 337-346 ◽  
Author(s):  
Christine W. Hartmann ◽  
Jennifer A. Palmer ◽  
Whitney L. Mills ◽  
Camilla B. Pimentel ◽  
Rebecca S. Allen ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Nursing Home ◽  
Culture Change ◽  
Frontline Staff ◽  
Home Culture ◽  
Research Instrument

ASPiH Conference 2019 keynote paper. Quality improvement through simulation: a missed opportunity?

2020 ◽  
Vol 6 (4) ◽  
pp. 193-195
Author(s):  
Paul O’Connor
Keyword(s):  
Quality Improvement ◽  
Education And Training ◽  
Working Environment ◽  
Delivery Of Healthcare ◽  
Simulation Research ◽  
Emergency Procedures ◽  
Use Of Technology ◽  
Simulation Based ◽  
Improving Patient Care ◽  
And Training

As the use of simulation has become more established in the delivery of healthcare education and training, there has been a corresponding increase in healthcare simulation research. Simulation-based research can be divided into research about simulation (answers research questions in which the focus is on simulation itself) and research through simulation (simulation as a method/tool for research). However, there are barriers, particularly for smaller less well-resourced simulation centres, that may prohibit participation in research. Therefore, it is suggested that quality improvement (QI) through simulation may be a pragmatic way in which simulation centres of all sizes can contribute to improving patient care beyond education and training. QI is defined as systematic, data-guided activities designed to bring about immediate, positive changes in the delivery of healthcare. Although not the case in healthcare, other industries routinely used simulation to support QI. For example, in aviation simulation is used to inform the design of the working environment, the appropriate use of technology, to exercise emergency procedures and to ‘re-fly’ flights following an adverse event as part of the mishap investigation. Integrating simulation within healthcare QI can support the development of novel interventions as well helping to address heretofore intractable issues.

scholarly journals ENHANCING STAFF-RESIDENT INTERACTIONS THROUGH A FRONTLINE STAFF QUALITY IMPROVEMENT INTERVENTION

2018 ◽  
Vol 2 (suppl_1) ◽  
pp. 791-792
Author(s):  
C Hartmann ◽  
J Palmer ◽  
C Pimentel ◽  
R Allen ◽  
S Zhao ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Quality Improvement Intervention ◽  
Frontline Staff ◽  
Improvement Intervention

A quality improvement project focused on assessment of risk level of outpatient psychiatry patients

2017 ◽  
Vol 41 (S1) ◽  
pp. s898-s898
Author(s):  
T. Tuvia ◽  
M. Kats ◽  
C. Aloezos ◽  
M. To ◽  
A. Ozdoba ◽  
...  
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Residency Training ◽  
Psychiatry Residency ◽  
Care Quality ◽  
Quality Improvement Project ◽  
Risk Level ◽  
List Type ◽  
Psychiatry Residency Training ◽  
Improvement Project

Since the implementation of the Clinical Learning Environment Review by the Accreditation Council for Graduate Medical Education, there has been an emphasis on training residents in health care quality as well as patient safety. As such, psychiatry residency training programs have had to incorporate quality improvement (QI) projects into their training. We developed a QI curriculum, which not only included resident and faculty participation, but also encouraged other staff in our department to focus on patient safety as well as improving their performance and the quality of care provided to the patients.In this poster, we present the development of our curriculum and will include a successful QI project to highlight this. This project focused on creating an algorithm to help assign patient risk level, which is based on evidence based risk factors. This project was created due to a survey conducted in our clinic which demonstrated that clinicians, and in residency training in particular, identifying and managing high risk patients can be anxiety provoking for trainees. We will present the specifics of this QI project, and additionally outline the steps that were taken to develop and integrate the QI project into clinical practice.Objectives(1) Learn how to successfully incorporate a QI project and curriculum into a psychiatry residency training program.(2) Understand both resident and faculty perspectives on what resources facilitated participation in QI.(3) Present the development of a quality improvement project focused on risk assessment of outpatient psychiatric patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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