scholarly journals Inspiring our future psychiatrists: a quality improvement project to optimise the medical student experience in community CAMHS settings

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S171-S171
Author(s):  
Brindha Anandakumar ◽  
Lois Nunn ◽  
Fanchea Daly ◽  
Ashleigh Dale
Keyword(s):  
Quality Improvement ◽  
Medical Student ◽  
Medical Students ◽  
Community Services ◽  
Quality Improvement Project ◽  
Grand Round ◽  
Clinical Activity ◽  
List Type ◽  
Improvement Project ◽  
Good Opportunity

AimsTo improve the structure, quality and experience of medical student placements in Community Child and Adolescent Mental Health Services (CAMHS). To increase the likelihood of pursuing a career in Psychiatry or CAMHS by 50% over their 3 week placement.BackgroundThere is evidence in the literature of the widely variable medical student experiences when it comes to Psychiatry placements. Medical students from Kings’ College London (KCL) have a 3 week placement in Lambeth Community CAMHS services. Despite this being a good opportunity for learning and development, the feedback from students reports that they often feel lost and were unable to fulfil the potential of the placement. The main challenges reported were identifying beneficial educational experiences and gaining clinically relevant exposure. This exposure includes getting involved beyond observation and following a patient longitudinally. These challenges will likely have a knock-on effect on their attitude towards Psychiatry and overall enjoyment of CAMHS placements when there is already a struggle to recruit trainee Psychiatrists.MethodA structured and immersive educational placement was designed through consultation with previous students, the multidisciplinary team and the university program directors. This included: •A new induction•Having a role in initial assessments of young people•Formalised medical and psychology teaching•Communication sessions•Case discussions in a ‘grand round’ format providing opportunity for end of placement assessmentFeedback was gathered using the Qualtrics analytical software, which was easily accessible through student's mobile devices.Pre placement questionnaires were used to assess the student's initial level of knowledge, expectations from the placement and motivation or interest in a career in CAMHS. Post placement questionnaires were used to assess any change in the above baseline scores. Brief, online feedback was collected after every clinical activity and was used to assess the interest and utility of each attended session during the placement. The questionnaire feedback was analysed and using these data, adjustments were made to improve the program for the next students in a “Plan-Do Study-Act” quality improvement methodology format. We analysed whether improving placement experience and learning affected students’ interest in careers in Psychiatry.ResultThe Quality Improvement Project is currently on-going and results are pending. So far, there is an improvement in student attendance and engagement following the introduction of induction, structure and active involvement in case management.ConclusionThe COVID-19 pandemic has resulted in community services having significantly reduced face to face contact, therefore our proposed changes for future cycles include various virtual elements. Ensuring medical students have access to online platforms such as Microsoft teams is vital in ensuring an effective medical student placement can be established Although the change to more remote working has been challenging , it is vital that medical students gain appropriate clinical experience during their Psychiatry placement to support further developments in Psychiatric recruitment.

A quality improvement project focused on assessment of risk level of outpatient psychiatry patients

2017 ◽  
Vol 41 (S1) ◽  
pp. s898-s898
Author(s):  
T. Tuvia ◽  
M. Kats ◽  
C. Aloezos ◽  
M. To ◽  
A. Ozdoba ◽  
...  
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Residency Training ◽  
Psychiatry Residency ◽  
Care Quality ◽  
Quality Improvement Project ◽  
Risk Level ◽  
List Type ◽  
Psychiatry Residency Training ◽  
Improvement Project

Since the implementation of the Clinical Learning Environment Review by the Accreditation Council for Graduate Medical Education, there has been an emphasis on training residents in health care quality as well as patient safety. As such, psychiatry residency training programs have had to incorporate quality improvement (QI) projects into their training. We developed a QI curriculum, which not only included resident and faculty participation, but also encouraged other staff in our department to focus on patient safety as well as improving their performance and the quality of care provided to the patients.In this poster, we present the development of our curriculum and will include a successful QI project to highlight this. This project focused on creating an algorithm to help assign patient risk level, which is based on evidence based risk factors. This project was created due to a survey conducted in our clinic which demonstrated that clinicians, and in residency training in particular, identifying and managing high risk patients can be anxiety provoking for trainees. We will present the specifics of this QI project, and additionally outline the steps that were taken to develop and integrate the QI project into clinical practice.Objectives(1) Learn how to successfully incorporate a QI project and curriculum into a psychiatry residency training program.(2) Understand both resident and faculty perspectives on what resources facilitated participation in QI.(3) Present the development of a quality improvement project focused on risk assessment of outpatient psychiatric patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

P34 Quality improvement project aimed at reducing gentamicin errors in neonates

2018 ◽  
Vol 103 (2) ◽  
pp. e1.38-e1 ◽  
Author(s):  
Calvert Heather ◽  
Makhalira Aubrey
Keyword(s):  
Quality Improvement ◽  
Transitional Care ◽  
Action Plan ◽  
Quality Improvement Project ◽  
Time Interval ◽  
List Type ◽  
Open Communication ◽  
Monthly Basis ◽  
Improvement Project ◽  
High Dependency

AimA level 3 tertiary neonatal unit with a capacity of 40 cots providing intensive care, high dependency care, special care & transitional care services, had 18 gentamicin errors reported between January and June 2017, with 84% errors occurring at prescribing and 16% errors in administration. The majority of errors (67%) were due to the complexity of calculating a 36-hourly time interval between doses. A quality improvement project was undertaken with the aim of reducing the number of gentamicin errors on the unit over a 3 month period.MethodAn overview of all gentamicin errors were presented to the multidisciplinary team (MDT) with a view of gathering ideas for improvement to ensure a team based approach. An action plan was put in place in line with National Patient Safety Agency (NPSA) recommendations1 and initiated in July 2017 based on a plan-do-study-act (PDSA) model.ResultsThe PDSA cycles included:a simplified and standardised dosing interval for dosing of gentamicin after the first dose.an updated local monograph with dosing intervals and example prescription.posters displayed in prescribing areas to promote safe and focused prescribing.a feedback session to the full MDT team regarding improvements made and further feedback.ensure compliance with policy by promoting updated guideline & on going error monitoring.consideration of alternative lower risk antibiotic in low risk babies.incorporation of gentamicin prescribing exercise as part of the new doctor induction. The following interventions will be evaluated in 3 months using Datix reported errors before and after implementation. Sequential PDSA cycles will then be conducted for learning and improvement.ConclusionA team based approach, using open communication with regular feedback and review is essential in order to improve the quality of prescribing and gain engagement from medical and non-medical prescribing colleagues. Further audit will be undertaken on monthly basis to evaluate the implementation of improvement measures.

scholarly journals Increasing the documentation of 48-hour antimicrobial reviews

2020 ◽  
Vol 9 (1) ◽  
pp. e000805
Author(s):  
Ramandeep Singh Sahota ◽  
Kiran Kasper Rajan ◽  
Jonathan Mark Sabine Comont ◽  
Hyungeun Hans Lee ◽  
Nikolina Johnston ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Medical Students ◽  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Antibiotic Use ◽  
Quality Improvement Project ◽  
Junior Doctors ◽  
Healthcare Team ◽  
Negative Consequences ◽  
Improvement Project

Antimicrobial resistance is a growing problem worldwide. Encouraging antimicrobial stewardship can help to reduce the negative consequences of inappropriate antibiotic use. This quality improvement project targets to do this by aiming to improve the proportion of 48-hour antimicrobial reviews completed and documented on two surgical wards at Darent Valley Hospital with a goal of 100% compliance.This project used four PDSA (plan, do, study, act) cycles to achieve our aim: a trust-wide email; education sessions with junior doctors; sticker reminders in patient notes; presenting our study to surgical consultants and displaying posters on the wards.The proportion of antimicrobial reviews completed at 48 hours in the patient notes increased from 18% to 77% over 19 weeks from 10 October 2018 to 20 February 2019. The most successful intervention was providing a presentation for consultants at an audit meeting in conjunction with displaying posters on the wards.The most successful interventions (education sessions with junior doctors and presentation to surgical consultants alongside displaying posters on the wards) were found to be those that required minimal further input after their initial rollout. This project was carried out by medical students and is highly transferrable to other hospitals, and highlighted that a successful quality improvement project can be undertaken by any member of the healthcare team.

Reducing pressure ulcers in care homes in Barnet: a quality improvement project

2020 ◽  
Vol 25 (Sup9) ◽  
pp. S33-S37
Author(s):  
Ugomma Anaba-Wright ◽  
Jemimah Kefas
Keyword(s):  
Quality Improvement ◽  
Pressure Ulcers ◽  
Training Session ◽  
Community Services ◽  
Quality Improvement Project ◽  
Care Homes ◽  
Pilot Training ◽  
Improvement Project ◽  
Untoward Event ◽  
Additional Support

Pressure ulcers are increasingly seen as an untoward event for patients. While there has been a strong focus on patients in the acute sector, community services have also had to be increasingly innovative in addressing this issue. Carers in care homes in the London borough of Barnet were identified as needing additional support to improve their knowledge and skills surrounding pressure ulcer prevention and treatment. An informal pilot training session showed that carers felt better equipped in terms of identifying new pressure ulcers and were able to escalate issues to district nurses in record time. Subsequently, there was a noticeable reduction in the reporting of pressure ulcers of categories 2 and above. In the present article, the authors describe the quality improvement project undertaken at Barnet care homes to prevent pressure ulcers.

scholarly journals Medical education and the quality improvement spiral: A case study from Mpumalanga, South Africa

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Martin Bac ◽  
Anne-Marie Bergh ◽  
Mama E. Etsane ◽  
Jannie Hugo
Keyword(s):  
Quality Improvement ◽  
Medical Students ◽  
Service Learning ◽  
Great Influence ◽  
Public Hospitals ◽  
Quality Improvement Project ◽  
Local Health ◽  
Medical Expert ◽  
Improvement Project

Background: The short timeframe of medical students’ rotations is not always conducive to successful, in-depth quality-improvement projects requiring a more longitudinal approach.Aim: To describe the process of inducting students into a longitudinal quality-improvement project,using the topic of the Mother- and Baby-Friendly Initiative as a case study; and to explore the possible contribution of a quality-improvement project to the development of student competencies.Setting: Mpumalanga clinical learning centres, where University of Pretoria medical students did their district health rotations.Method: Consecutive student groups had to engage with a hospital’s compliance with specific steps of the Ten Steps to Successful Breastfeeding that form the standards for the Mother- and Baby-Friendly Initiative. Primary data sources included an on-site PowerPoint group presentation (n = 42), a written group report (n = 42) and notes of individual interviews in an end-of-rotation objectively structured clinical examination station (n = 139).Results: Activities in each rotation varied according to the needs identified through the application of the quality-improvement cycle in consultation with the local health team. The development of student competencies is described according to the roles of a medical expert in the CanMEDS framework: collaborator, health advocate, scholar, communicator, manager and professional. The exposure to the real-life situation in South African public hospitals had a great influence on many students, who also acted as catalysts for transforming practice.Conclusion: Service learning and quality-improvement projects can be successfully integrated in one rotation and can contribute to the development of the different roles of a medical expert. More studies could provide insight into the potential of this approach in transforming institutions and student learning.

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