scholarly journals Clinical Audit cycle of Mental Health Act (MHA) documentation for patients on section 3 staying 90 days and over in adult wards at Roseberry park hospital

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S345-S345
Author(s):  
Rohini Ravishankar ◽  
Raj Kumar ◽  
Ramanand Badanapuram

AimsTo complete the audit cycle on compliance of MHA documentation (including MCA1 form at admission and 3 months, T2 form, SOAD request and T3 form authorization) on patients on section 3 staying 90 days and over in adult wards at Roseberry park hospitalMethodIn the initial audit, we collected data from all inpatients on section 3 staying 90 days and over, in Adult acute and rehab wards on Roseberry park hospital between the time period 28/10/19–04/11/19. Using a designated audit data collection tool, information was gathered from each patient's electronic record pertaining to the standards. The same method was used in re-audit where data were collected from all inpatients on section 3 staying 90 days and over in Adult acute wards on Roseberry park hospital between the time period 04/11/20–11/11/20. To note, the rehab ward at Roseberry park hospital was closed in Feb 2020. The data were analysed by the project lead.ResultIn the initial audit, 16 patients records were identified as meeting criteria,out of these 7 (44%) patients were on acute wards and 9 (56%) at rehab ward. Where as in re-audit 5 patients records were identified as meeting criteria and all were on acute wards. Days in Hospital - Ranged from 120 days to 664 days, average being 295 days and median of 186 days in the initial audit compared to121 days to 290 days, average being 170 days and median of 150 days in the reaudit. Percentage of patients records with documented capacity assessment at admission and 3 months were same at 80% and 60% respectively in both audits.T2 form was completed in all consenting patients in both audits. SOAD request sent was recorded in only 1 (25%) patient in the reaudit, which was lower than the initial audit, where in SOAD request was sent in 7 (78%) patients but recorded in 5 (56%) of them. For patients lacking capacity, T3 form was documented only in 4 (45%) patients but T3 form authorisation was discussed with patient and evidenced in case notes in only 1(11%) case in the initial audit, where as in reaudit T3 form was not documented or discussed for any patient.ConclusionThere needs to be improvement in MHA documentation for detained patients.

Author(s):  
Christopher Joyce ◽  
Rizwan Rajak

Abstract Objectives Rheumatoid arthritis (RA) has an affinity to smaller joints, thus its effect on the foot/ankle is widely known. Despite this, there is lack of adherence to foot management standards by podiatrists. This research aimed to audit the adherence of these standards and compare them to well-established management standard adherence in the diabetic foot. Methods In this clinical audit, data was obtained via six National Health Service (NHS) podiatry departments in North-East London on service provision, management, treatment and professional development on both RA and diabetic foot health via foot management clinical audit tools. Descriptive analyses were conducted analysed to identify patterns and trends, with set standard compliance conditions calculated on Net Promotor Score ® (NPS) metric to allow for multi-comparison. Results All areas of RA foot health management were found to have poor compliance when compared to diabetes foot health management. When using NPS, no trust audited meet the majority of foot health standards in RA; with only two having a positive score (meeting the minimum standards) compared to all trusts posting a positive NPS on diabetes foot health standards. Conclusions Our results indicate that poor compliance into RA foot health standards is prevalent across the audited region and may be resulting in worsening foot outcomes despite a paradigm shift in other areas of RA management. Enhanced training and knowledge is required for better adherence to the standards set out and improve a foot health management in RA.


2019 ◽  
Vol 49 (8) ◽  
pp. 1001-1006
Author(s):  
Linda Mileshkin ◽  
Catherine Dunn ◽  
Hannah Cross ◽  
Mary Duffy ◽  
Mark Shaw ◽  
...  

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S324-S324
Author(s):  
Tanzida Haque ◽  
Mosab Mohammed Jodat Ibrahim ◽  
Bapu Ravindranath

AimsThe aim of this audit is to explore the possible causes of clinic cancellation in an inner city CMHT and the recommendation to reduce the burden.BackgroundCancellations of planned appointments have been a major and long-standing problem for healthcare organisations across the world. It represents a significant loss of revenue and waste of resources, have significant psychological, social and financial implications for patients and their families and represent a significant loss of training opportunities for trainees. Re-scheduling appointment is one of the major issues of inconvenience to the patients. It also increases workload for the patient appointment team.MethodData have been collected retrospectively from patient appointment booking team regarding clinic cancellation with causes of cancellation recorded in the system (01/07/2019–30/09/2019). The investigators have investigated if the cancellation has been made when it was absolutely necessary to cancel the clinic (Unavailability of doctors due to leave/on calls) and if patients have been informed at least 8 weeks prior to the appointed clinic as per trust protocol.ResultTotal number of 193 clinics were booked at the CMHT from July 2019 – September 2019. About 54% clinics were cancelled during the time period. The Clinic Cancellation rate was higher in September (68%) and was lowest in August (30.30%). As the month of July is the changeover period for trainees, the number of clinics booked during August was relatively less than normal. 72% clinics were cancelled by junior doctors and 28% clinics were cancelled by consultants at the CMHT. The major cause of clinic cancellation was unavailability of the junior doctors due to on call (31.58%) which was not communicated to the patient appointment booking team. Due to annual leave, 25% clinics were cancelled and 21% clinics were cancelled due to study leave. In both cases it is evident that, lack of communication between clinicians and patient appointment team are primarily responsible for hospital-initiated clinic cancellations. As per Patient Appointment booking team, around 50% cases, patients were informed 8 weeks in advance before cancelling the clinics.ConclusionThis is evident from this audit that the number of hospital-initiated clinic cancellations can be reduced by improving communication between Patient Appointment booking service, Medical staffing department and clinicians. The findings of the audit have been shared locally with CMHT managers, clinicians and with the patient appointment booking team.


2019 ◽  
Vol 10 (6) ◽  
pp. 93-97
Author(s):  
Arunava Biswas ◽  
Sukanta Sen ◽  
Krishnangshu Ray

Background: Pretest-posttest questionnaire are often used during workshop to assess the impact of a program on the participants. However, the reliability of such data collection ‘tool’ is not often judged. There is lack of evidence supporting the authentication of such research instrument. Aims and Objective: This study was conducted to assess the reliability of prepost test questionnaire comprising MCQs, on participants attending a one-day workshop on clinical pharmacology at a teaching hospital in eastern India. Materials and Methods: Pre and post test questionnaire comprising 15 MCQs covering different aspects of ‘Good Clinical Practices’ on which several presentations were later delivered by experts were distributed to (n=42) participants in a one-day oriented workshop within stipulated time period and their feedback were collected and statistically analyzed after the workshop was over. Results: The average number of MCQs attempted in the pretest questionnaire was 12.42 and in posttest were 14.44 by the participants. The workshop participants increased their percentage of correct answer score from an average of 48.4 in pretest to a statistically significant 88.73 in posttest (p<0.0001). Conclusion: Pre/post questionnaire could be effective and reliable tools in meeting stipulated learning objectives and help in assessing the aftermath of an educational program.


2001 ◽  
Vol 25 (5) ◽  
pp. 172-174 ◽  
Author(s):  
M. Phipot ◽  
H. Hales ◽  
B. Sheehan ◽  
S. Reeves ◽  
M. Lawlor

Aims and MethodTo determine the rates at which clinical teams within one NHS trust placed older people on a Care Programme Approach (CPA) register and to examine the degree to which clinicians' use of the register conformed to trust policy. Two retrospective case notes surveys were carried out 6 months apart within a completed audit cycle.ResultsConsultant teams varied considerably in their application of the CPA policy. Feedback to clinicians after the first survey had a variety of effects on subsequent use of the CPA register.Clinical ImplicationsHealth service policies exist to reduce variation in clinical practice and to ensure minimum standards. Clinical audit may be a useful tool in identifying irrational variation within the framework of clinical governance.


2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Bradley Viner

<p>Embracing EBVM as a concept is an important first step, but is of little value unless it is translated into an improvement in patient care. This session will discuss how EBVM can be incorporated into clinical guidelines at a practice level, using a team-based approach to maximise concordance. The pros and cons of using practice guidelines as a means of improving clinical effectiveness will be discussed, followed by an illustration of how the clinical audit cycle can be used as a tool to ensure that Best Practice as a established by practice guidelines is applied to produce an improvement in clinical performance.</p><p> <a href="/index.php/ve/article/view/95/128"><img src="/public/site/images/bridget/Bradley_twitte_image.PNG" alt="" /></a></p><br /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access" />


Author(s):  
NASREEM BIBI ◽  
BAHTA WARA ◽  
SAQIB MUGHAL ◽  
HANA MORRISSEY ◽  
PATRICK BALL

Objective: The aim of this scoping study was to identify gaps in the current literature and understand the T2DM and MIH comorbidity trends in the local population from the West Midlands, UK to inform future studies. Methods: This project was a scoping study of two parts; a critical review and a clinical audit. A thematic approach was used to group studies based on their overall study outcome. The clinical audit data was used to compare the local patient population to the patterns identified in the literature reviewed. Results: The reviewed studies reported a relationship between T2DM control and both depression and anxiety, but did not agree on its significance. The clinical audit of 71 patients diagnosed with T2DM showed that 73% of males presented with poor diabetes control (HbA1c>7) compared to females (46%). Conversely, females exhibited a higher prevalence of MIH (45%) compared to males (31%). Conclusion: From both this audit of the literature and local data, it remains unclear whether mental-ill health is a major driver for medication non-adherence behaviour and uncontrolled diabetes. Further studies are recommended to further understand this comorbidity.


2016 ◽  
Vol 40 (4) ◽  
pp. 187-191 ◽  
Author(s):  
Jonathan Radcliffe ◽  
Laura Bird

Aims and methodWe report the results of a clinical audit of patients' reactions to two types of talking therapy groups facilitated by assistant psychologists and psychology graduates on three acute wards. Patients' experiences of problem-solving and interpersonal group formats were explored via focus groups and structured interviews with 29 group participants.ResultsBoth group formats generated high satisfaction ratings, with benefits related mostly to generic factors.Clinical implicationsAdequately trained and supported assistant psychologists and psychology graduates can provide supportive talking groups that patients find helpful.


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