scholarly journals Audit of follow-up within 7 days on discharge from the mental health unit, Forth Valley Royal Hospital

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S225-S226
Author(s):  
Matthew Turner ◽  
Shaun Love ◽  
Fergus Douds ◽  
Anyssa Zebda
Keyword(s):  
Mental Health ◽  
Health Unit ◽  
Post Discharge ◽  
Royal Hospital ◽  
Increased Risk ◽  
Discharge Policy ◽  
Adult Psychiatry ◽  
Scheduled Care ◽  
Mental Health Unit

AimsTo determine compliance with the new discharge policy of review within 7-days for all General Adult Psychiatry patients discharged from Forth Valley Royal Hospital.BackgroundIt is well established that there is an increased risk of suicide following discharge from Inpatient Psychiatric Wards. This risk is significantly increased in the first month, and particularly high in the first week.In their 2016 Guidance, NICE recommends follow-up within 7 days of discharge. It is not known whether seven day follow-up reduces suicide risk but it is clearly an opportunity for risk assessment and management during a particularly risky period.This standard was adopted by the General Adult Wards in Mental Health Unit at Forth Valley Royal Hospital in April 2019.MethodAll discharges from Wards 1, 2 and 3, Forth Valley Royal Hospital were reviewed during three distinct, month-long periods:November 2018 (prior to the introduction of the new discharge policy)May 2019 (shortly after the introduction of the new discharge policy)September 2019 (six months after the introduction of the new discharge policy)A list was obtained from Medical Records of all General Adult patients discharged in these periods. The paper and electronic records were checked for each patient, and the first scheduled care episode post discharge was taken as follow-up.ResultIn the1st round of audit (November 2018): 41 patients were discharged and 26 patients (64%) received follow-up within 7 days.In the 2nd round of audit (May 2019): 46 patients were discharged, 39 patients (84%) received follow-up within 7 days.In the 3rd round of the audit (September 2019), 50 patients were discharged and 49 (98%) received follow-up within 7 days.ConclusionThere has been a clear improvement in the provision of follow-up on discharge from the General Adult Psychiatry Wards in Forth Valley Royal Hospital.The new discharge policy was implemented in April 2019 and a “Discharge Pause” was introduced (initially a sticker, now an electronic form) to be completed by the medical team at the point when it was decided to discharge.Community Mental Health Teams have also been reminded of their need to facilitate seven day follow-up as a priority. A flowchart was produced in May 2019, which provided guidance as to who should provide the seven day follow-up.

scholarly journals Audit of disposal of clinically confidential information

2004 ◽  
Vol 28 (9) ◽  
pp. 324-325 ◽  
Author(s):  
Craige Dietrich ◽  
Zahir Khan ◽  
James Warner
Keyword(s):  
Mental Health ◽  
Patient Care ◽  
Clinical Implications ◽  
Sensitive Information ◽  
Health Unit ◽  
Confidential Information ◽  
Safe Disposal ◽  
Highly Sensitive ◽  
Mental Health Unit

Aims and MethodWe conducted a 3-cycle audit of disposal of clinically sensitive information in a mental health unit, in order to identify and reduce potential breaches in patients' confidentiality. Material from waste bins in administrative areas of a mental health unit was examined every evening during each period of the audit.ResultsThe first search, conducted over a 3-week period, yielded 11 documents containing highly-sensitive information about patients. After feedback to staff and improvement of shredding facilities, no sensitive information was found during the follow-up 3-week survey, 3 months later. However, a third survey 2 years later found 24 highly-sensitive items after one week, despite shredding facilities being maintained.Clinical ImplicationsChanges in behaviour identified in this audit appear to be due to education rather than improved facilities. All staff involved in patient care need to maintain awareness of the need for safe disposal of confidential material.

scholarly journals 15 Structured Geriatric Liaison Services in Mental Health Inpatient Facilities

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i1-i8
Author(s):  
B Babu ◽  
A Khalid ◽  
S Sadiq ◽  
J Essem ◽  
E Ruiz-Mendoza
Keyword(s):  
Mental Health ◽  
Psychological Symptoms ◽  
Health Facilities ◽  
Physical Aspect ◽  
Health Unit ◽  
Staff Support ◽  
Increased Risk ◽  
Mental Health Facilities ◽  
The Impact ◽  
Mental Health Unit

Abstract Introduction Older people admitted to mental health facilities may be at increased risk of deterioration in the physical co-morbidities and increased rates of mortality when admitted in acute medical settings. Our model of care focuses on intervening in the physical aspect of patients admitted in the mental health unit addressing their comorbidities and polypharmacy and offering staff support during the admission process. Our Older Mental Health Unit is based in the district hospital with a total of 22 beds for people over 65 years old distributed in two areas: dementia with behavioral and psychological symptoms (BPS) and functional disorders. Methods Allocated geriatrician once a week to attend MDT and medical ward rounds. 5 working days telephone consultations for advice and supporting trainees in teaching and research. We measure the impact of our intervention comparing the data predating our intervention comparing 20 patients in each period 2016 and 2018. Results Mean age increased from 74.3 to 77.8 in a two year period with an average of 3.5 medical co-morbidities. Reduction in polypharmacy from 7.15 to 5.5 number of medication, 58% reduction in the number of hospital transfers and 90% reduction in specialty referrals. Conclusions Structured Geriatric Liaison Services in Mental Health in inpatient facilities are shown to be effective in reducing acute hospital and outpatient clinic attendances minimising the challenges of management of these patients in non-mental health facilities.

Ensuring quality immediate discharge letters from mental health

2018 ◽  
Vol 31 (6) ◽  
pp. 545-551
Author(s):  
Taylor Watson-Fargie ◽  
Ross Cheape
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Design Methodology ◽  
Inpatient Admission ◽  
Patient Transfer ◽  
Royal Hospital ◽  
Content Type ◽  
Mental Health Unit ◽  
Reason For Admission

Purpose Immediate discharge letters (IDLs) from the mental health unit at Forth Valley Royal Hospital are vital in ensuring safe patient transfer to primary care. The purpose of this paper is to develop a standardised list of information that should be included in all IDLs, and to assess its use in practice. Design/methodology/approach Three audit cycles analysed IDLs over two-week periods for their inclusion of the standardised list. The data were assessed qualitatively. Findings Baseline measurement showed 48.7 per cent of discharges had a brief reason for admission, 15.4 per cent included a description of the patient’s progress during inpatient admission, 35.9 per cent had medication alterations included and 23.1 per cent included follow-up arrangements. Following a series of interventions, analysis of subsequent IDLs demonstrated that 76.2 per cent of discharges had a brief reason for admission, 76.2 per cent included a description of the patient’s progress during inpatient admission, 76.2 per cent had medication alterations included and 71.4 per cent included follow-up arrangements. Originality/value The standardised list developed will ensure quality communication and safe patient transfer to primary care; the application of this list was effective and cost neutral.

The contribution of a mobile mental health unit to the promotion of primary mental health in rural areas in Greece: A 2-year follow-up

2011 ◽  
Vol 26 (7) ◽  
pp. 425-427 ◽  
Author(s):  
V. Peritogiannis ◽  
C. Mantas ◽  
D. Alexiou ◽  
V. Fotopoulou ◽  
V. Mouka ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Rural Areas ◽  
Health Unit ◽  
Mobile Mental Health ◽  
Northwestern Greece ◽  
Mental Health Unit

AbstractDuring the 2 years of the mobile mental-health unit's operation in Northwestern Greece, the referrals increased rapidly with 29.4% of patients never having received mental-health care before, while hospitalizations and relapses reduced significantly, indicating that community-oriented programs can contribute greatly to successfully addressing the needs of patients in remote rural areas.

Descriptive Study of Adjustment Disorders in a Mental Health Unit.

2017 ◽  
Vol 41 (S1) ◽  
pp. S607-S607
Author(s):  
L. González ◽  
B. Pecino ◽  
C. Gomez ◽  
M. Anibarro ◽  
C. Ortigosa
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Care Physician ◽  
Psychiatric Evaluation ◽  
Adjustment Disorders ◽  
Health Unit ◽  
Social Difficulties ◽  
Current Employment Status ◽  
Competing Interest ◽  
Mental Health Unit

IntroductionAdjustment disorders are a common psychiatric disorder in primary care and mental health units, with point prevalence estimates ranging from 0.9% to 2.3%. These disorders have been recently defined as a stress response syndrome in the fifth edition of the DSM, causing emotional and social difficulties and also a large economic burden on society.ObjectivesThe aim of this descriptional study was to analyse the socio-demographic characteristics and treatment of the patients diagnosed with adjustment disorders in the first visit in a mental health unit.MethodsThe study sample consisted of 128 patients admitted for a psychiatric consultation in a mental health unit in Alicante (Spain) from their primary care physician, between February and July 2016. Variables of gender, age, current employment status, diagnosis and treatment were measured. Data analysis was conducted using SPSS software.ResultsThe data from 31 patients who were diagnosed with adjustment disorders meant a 24% of the sample. The median age was 47 years old in the adjustment disorders group. Among those with adjustment disorders, 61% were women, and 52% of them were unemployed. Almost 60% of them had at least one pychotropic prescription and only 22% were derived to psychology.ConclusionsAdjustment disorders are considered as an intermediate category between no mental disorder and affective disorders. Most authors recommend to start with a psychotherapeutic intervention. Despite starting with medication has not proved effectiveness in the studies, most of the patients had at least one psychotropic prescription before the psychiatric evaluation.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Predictors of clinical deterioration in patients with suspected COVID-19 managed in a ‘virtual hospital’ setting: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e045356
Author(s):  
Nick A Francis ◽  
Beth Stuart ◽  
Matthew Knight ◽  
Rama Vancheeswaran ◽  
Charles Oliver ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Hospital Setting ◽  
Health Problems ◽  
Clinical Deterioration ◽  
Care Services ◽  
Increased Risk ◽  
Remote Assessment ◽  
History Of

ObjectiveIdentify predictors of clinical deterioration in a virtual hospital (VH) setting for COVID-19.DesignReal-world prospective observational study.SettingVH remote assessment service in West Hertfordshire NHS Trust, UK.ParticipantsPatients with suspected COVID-19 illness enrolled directly from the community (postaccident and emergency (A&E) or medical intake assessment) or postinpatient admission.Main outcome measureDeath or (re-)admission to inpatient hospital care during VH follow-up and for 2 weeks post-VH discharge.Results900 patients with a clinical diagnosis of COVID-19 (455 referred from A&E or medical intake and 445 postinpatient) were included in the analysis. 76 (8.4%) of these experienced clinical deterioration (15 deaths in admitted patients, 3 deaths in patients not admitted and 58 additional inpatient admissions). Predictors of clinical deterioration were increase in age (OR 1.04 (95% CI 1.02 to 1.06) per year of age), history of cancer (OR 2.87 (95% CI 1.41 to 5.82)), history of mental health problems (OR 1.76 (95% CI 1.02 to 3.04)), severely impaired renal function (OR for eGFR <30=9.09 (95% CI 2.01 to 41.09)) and having a positive SARS-CoV-2 PCR result (OR 2.0 (95% CI 1.11 to 3.60)).ConclusionsThese predictors may help direct intensity of monitoring for patients with suspected or confirmed COVID-19 who are being remotely monitored by primary or secondary care services. Further research is needed to confirm our findings and identify the reasons for increased risk of clinical deterioration associated with cancer and mental health problems.

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