Abstract

AimsThe local audit aimed at measuring awareness of research and development policies and implementation of local and national standards. Our findings generated a quality improvement project with two main objectives: first, improving patient approach and recruitment in research and second, improving trainee satisfaction within our trust.MethodA cohort of new inpatient admissions was identified over a period of 4 weeks, between October 2019 and November 2019, on the two psychiatric wards at the Briary Wing, Harrogate District Hospital. Based on local and national standards, we designed and developed a qualitative (questionnaire) and quantitative (audit tool) approach that was aimed at both staff and patients. Our steps included: assessing awareness and implementation of standards, a retrospective collection of data on the wards, and analysis of the data in Microsoft Excel.ResultOnly one ward implemented the local guidance from which we identified a sample of 14 consecutive new admissions that were currently present on the ward and were able to answer our questions. 13 of those patients were noted as ‘approached’ on our visual board from which only 3 patients remembered reading a leaflet about research options in the admission pack, however, they have not been verbally informed. There was no process in place to assure the re-approaching of initially unwell patients or to follow up on discharge for those interested. Documentation was available in only 9 of the cases and was nonspecific: ‘admission pack done’.ConclusionThe awareness and understanding of Research and Development policies are poor and they are difficult to apply in practice in a busy inpatient environment without a clear process in place. This results in patients missing the opportunity to learn and understand more about research or to participate in ongoing studies. Quality improvement work needs to be done to improve patient recruitment in research in inpatient settings. Simple flow charts and stepwise processes as exemplified by our action plan have the potential to improve service quality, as well as patient and trainee satisfaction.

Highlights

  • 78% (n = 14) of patients were on track to meet, or had already met, the NICE standard of 3-monthly serum lithium level

  • 83% (n = 15) of patients met the NICE standards of 3 monthly renal tests, thyroid function test was performed in 89% (n = 16) and at least one serum calcium level was documented in 63% (n = 15)

  • Our findings highlight the need for three monthly renal function monitoring in older adults prescribed lithium given the additive adverse effects of increasing age and lithium on the kidney

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Summary

Introduction

78% (n = 14) of patients were on track to meet, or had already met, the NICE standard of 3-monthly serum lithium level. 83% (n = 15) of patients met the NICE standards of 3 monthly renal tests, thyroid function test was performed in 89% (n = 16) and at least one serum calcium level was documented in 63% (n = 15). Half (n = 9) were initiated on lithium by POA service and of these, 56% (n = 5) had documented renal impairment prior to initiation.

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Conclusion
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