Abstract
Aims and methodTo increase the proportion of patients with no psychotropic drug discrepancies at the community mental health team (CMHT)-general practice interface. Three CMHTs participated. Over a 14 month period, quality improvement methodologies were used: individual patient-level feedback to patient's prescribers, run charts and meetings with CMHTs. RESULTS: One CMHT improved medicines reconciliation accuracy and demonstrated significant reductions in prescribing discrepancies. One in three (119/356) patients had ≥1 discrepancy involving 20% (166/847) of all prescribed psychotropics. Discrepancies were graded as: 'fatal' (0%), 'serious' (17%) and 'negligible/minor harm' (83%) but were associated with extra avoidable prescribing costs. For medicines routinely supplied by secondary care, 68% were not recorded in general practice electronic prescribing systems.Clinical implicationsImprovements in medicines reconciliation accuracy were achieved for one CMHT. This may have been partly owing to a multidisciplinary team approach to sharing and addressing prescribing discrepancies. Improving prescribing accuracy may help to reduce avoidable drug-related harms to patients.Declaration of interestNone.
Highlights
improvements in medicines reconciliation accuracy were achieved for one CMHT
This may have been partly owing to the multidisciplinary team approach to sharing
Quality improvement methodologies were used from October 2015 to January 2017
Summary
Psychiatric patients comprise a minority of emergency department presentations, they require a disproportionate amount of time and resources, which can frustrate emergency department staff and cause negative attitudes towards such patients.[5,6] Myriad factors underlie this, such as lengthy waiting times, interpersonal difficulties and procedural ambiguity. These factors are often longstanding and resistant to change, but lean management processes, when executed appropriately, are an accessible and effective way of effecting meaningful change. In addition to contributing to an unpleasant work environment, interpersonal conflicts interfere with provision
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