You are here

  • Home
  • Archive
  • Volume 8, Issue 4
  • Development and implementation of electronic medical handovers across psychiatric hospitals: quality improvement initiative

Article Text

Article menu

Download PDFPDF

XML
Quality improvement report
Development and implementation of electronic medical handovers across psychiatric hospitals: quality improvement initiative
  1. Luke Skelton1,
  2. Jonathan Rogers2,
  3. Chris Kalafatis, Consultant in Old Age Psychiatry3
  1. 1John Dickson Ward, South London and Maudsley NHS Foundation Trust, London, UK
  2. 2Specialty Registrar, South London and Maudsley NHS Foundation Trust &Wellcome Trust Clinical PhD Fellow, University College London, London, UK
  3. 3Clinical Trials, South London and Maudsley NHS Foundation Trust, London, UK
  1. Correspondence to Dr Luke Skelton; luke.skelton{at}slam.nhs.uk

Abstract

A lack of integration between internal processes and failure to use the full potential of information technology (IT) systems is common in psychiatric hospitals. We aimed to reduce the number of out-of-hours medical errors by ensuring that there is consistent and transparent weekend medical handover by creating an electronic handover system that is easy to use, robust and embedded into the existing trust IT systems. We employed quality improvement (QI) methodology to address this issue.

After trialling in a single site followed by six cycles of improvement, the weekend medical handover system is now in use across four boroughs and has been integrated into trust policy. It has received qualitative and quantitative evidence of improvement, with 100% of doctors reporting the system improved patient care and a 64% (from 11 to 4 events/year) reduction in moderate, severe and catastrophic adverse incidents occurring out-of-hours within the older adult service (p=0.29, χ2 1.117).

The increasing number of complex patients with comorbid medical illness in psychiatric inpatient services demands robust handover systems similar to that of an acute trust. This QI work offers a template for achieving this across other psychiatric trusts and demonstrates the positive change that can be achieved.

  • quality improvement
  • medical handover
  • safe
  • psychiatry

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjoq-2019-000630

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors LS and JR designed and conducted the study with overview of the project by CK. LS wrote and submitted the article with review and input from both JR and CK.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.