scholarly journals Assessing the practice of written referrals to neuroradiology and how this process can be improved and standardised

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S181-S182
Author(s):  
Fraser Currie ◽  
Rashi Negi ◽  
Hari Shanmugaratnam
Keyword(s):  
Quality Improvement ◽  
Scoring Systems ◽  
Quality Improvement Project ◽  
Cortical Atrophy ◽  
Secondary Outcome ◽  
Quality Improvement Initiative ◽  
Exclusion Criteria ◽  
Quality Of Information ◽  
Improvement Project

AimsThis quality improvement project aims to improve the quality of information provided in the referrals from the older adult psychiatry department to radiology when requesting neuroradiological imaging.The secondary outcome aims to standardise information on the referral proforma. We hypothesise that this improved referral proforma will lead to improved quality of reporting from the radiology department, which will form the second stage of this quality improvement project.A further area of interest of this exercise is to establish whether standardised radiological scoring systems are requested in the referral, as these can be utilised as a means to standardise reported information.MethodRetrospective electronic case analysis was performed on 50 consecutive radiology referrals for a period of 3 months from November 2019 to January 2020. Data were obtained from generic MRI and CT referral proforma and entered into a specifically designed data collection tool. Recorded were patient demographics, provisional diagnosis, modality of imaging, use of ACE-III cognitive score, radiological scoring systems, and inclusion and exclusion criteria.ResultResults from 50 referrals have shown: 60% were male, 40% female. Average patient age of 74, ranging from 49 to 95. 58% were referred for CT head with 42% for MRI head. More than half of referrals quoted the ACE-III score. 26% of referrals stated exclusion criteria such as space occupying lesions, haemorrhages or infarcts. 10% of referrals requested specific neuro-radiological scoring scales. Specific scales which were requested included GCA (global cortical atrophy), MTA scale (medial temporal atrophy), Koedam scale (evidence of parietal atrophy) and Fazekas (evidence of vascular changes). Only 80% of referrals included the patients GP details on the referral form.Conclusion1. This quality improvement initiative has highlighted that the current level of information in referring patient to radiology is variable and dependent on the referrer.2. All referrals should state exclusion criteria as per the NICE guidelines on neuroimaging in diagnosis of dementia.3. Preliminary evidence suggests that requesting specific radiological rating scales could improve the quality of information received in the imaging report. The second part of this quality improvement initiative will aim to explore the impact of requesting these scales routinely.

A quality improvement project to reduce restrictive interventions in a mental health service

2021 ◽  
pp. 1-12
Author(s):  
Darren Savarimuthu ◽  
Katja Jung
Keyword(s):  
Mental Health ◽  
Quality Improvement ◽  
Positive Impact ◽  
Essential Elements ◽  
Quality Improvement Project ◽  
Psychiatric Ward ◽  
Quality Improvement Initiative ◽  
Successful Implementation ◽  
Evidence Based ◽  
Improvement Project

Background/aims This article describes a quality improvement project that aimed to reduce restrictive interventions on an acute psychiatric ward. In light of a service level agreement and based on a trust-wide target, the purpose of the project was to reduce restrictive interventions by 20% within a period of 6 months. It was also anticipated that a least restrictive environment could have a positive impact on patient experience. Methods Three evidence-based interventions were introduced to the ward during the quality improvement project. These included positive behaviour support, the Safewards model and the productive ward initiative. Results There was a 63% reduction in restrictive interventions over a 6-month period through the successful implementation of a series of evidence-based interventions to manage behaviours that challenge on the mental health ward. Conclusions The project identified collaborative team working, staff training and adequate resources as essential elements in the success of the quality improvement initiative. However, co-production was found to be crucially significant in bringing sustainable changes in ward environment and in addressing restrictive practices.

scholarly journals A Quality Improvement Project to Increase the Rate of HPV Vaccination Initiation in Adolescents

2018 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Quality Improvement ◽  
Hpv Vaccination ◽  
Vaccination Rate ◽  
Quality Improvement Project ◽  
Human Papilloma Virus Vaccine ◽  
Quality Improvement Initiative ◽  
Initiation Rate ◽  
Improvement Project ◽  
Vaccination Rates ◽  
Implementation Period

The vaccination rate of the human papilloma virus vaccine [9vHPV] is low, with only 63% of eligible females and 50% eligible males receiving the vaccine in 2016. The aim of this quality improvement project was to increase the initiation rate of HPV vaccination at Smyrna Pediatrics by 20%, from 3.6% to 4.3% over four weeks. Two physicians, one nurse practitioner, and two medical assistants implemented this quality improvement initiative. There is a lack of education and standardized communication about HPV and 9vHPV to prevent against the virus. A standardized script was created so that all conversations between healthcare professionals and patients and their parents or guardians included the wording of the 9vHPV being recommended rather than optional. Educational material from the CDC was the standard handout given to each adolescent and their parent or guardian. Standardized education and communication was to be provided at each adolescent visit of the 125 eligible adolescents seen during the four-week implementation period, 4% (n = 5) agreed to receive the 9vHPV vaccine. With a baseline of 3.6% (n = 4), there was an 11.1% increase of initiation of 9vHPV. The use of standardized education documents presented to all patients and their parents or guardians established health education as the mainstay of the project and provided information about the importance of prevention and protection from the virus that the vaccine prevents. The implementation of results over a longer period of time may prove to be more effective for the practice’s increase of vaccination rates overall.

scholarly journals 55 Quality Improvement Project to Assess How Informed Patients are About do not Attempt Cardiopulmonary (DNACPR) Decisions?

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i14-i17
Author(s):  
P Jayasuriya ◽  
Y Amanullah ◽  
A Kumar ◽  
C Hookey
Keyword(s):  
Quality Improvement ◽  
Medical Staff ◽  
Quality Improvement Project ◽  
Next Of Kin ◽  
Geriatric Ward ◽  
Improvement Project ◽  
Information Leaflets ◽  
Journal Clubs ◽  
Weekly Journal

Abstract Introduction Despite growing evidence regarding DNACPR decisions, there is a paucity of information given to patients regarding resuscitation decisions. The main aim of this quality improvement project was to assess and improve patients’ and their relatives’ understanding about DNACPR decisions. Intervention We initially surveyed 30 inpatients or their next-of-kin (if the patient lacked capacity) in a geriatric ward who had DNACPR decisions in place. Although, 86% knew the implications of a DNACPR decision, only 50% knew that a DNACPR decision would not limit them from receiving other treatment. 66% reported that the information given by the healthcare professional is “too little”. 35 questionnaires were also given to doctors of all grades to assess their practice of DNACPR discussions and barriers for discussion. Majority (95%) of doctors knew what should be included in a DNACPR discussion. Medical staff not considering DNACPR discussions during assessment, medical staff not comfortable to make the DNACPR decision and the fear of distressing the patient are the three main issues that were highlighted as barriers. 17% of doctors reported that they would have attended a cardiac arrest at least on 2-5 occasions for a patient when resuscitation was futile. We presented this data and educated doctors on effective DNACPR discussions using video demonstrations in weekly journal clubs. All doctors were informed to distribute DNACPR Improvement After the intervention, only 80% understood the DNACPR discussion. 76% knew that DNACPR does not limit them from receiving other treatment. 73% reported that this was not stressful and 76% were satisfied with the discussion and reported that their questions were answered adequately. 11 out of 30 patients had received the information leaflets and all found it useful. Discussion Although after the intervention the percentage who understood the DNACPR decision had reduced compared to the initial audit, there was a 20% improvement in who knew that DNACPR decisions did not limit other treatment. We hope to extend this study by carrying out training sessions for doctors to improve the quality of these conversations and thereby enhance adherence to expected practice in DNACPR decision making.

Quality of telephone-based cancer symptom management by nurses: a quality improvement project

2020 ◽  
Vol 29 (2) ◽  
pp. 841-849
Author(s):  
Dawn Stacey ◽  
Claire Ludwig ◽  
Lynne Jolicoeur ◽  
Meg Carley ◽  
Katelyn Balchin ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Symptom Management ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Cancer Symptom Management
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