Development and implementation of electronic medical handovers across psychiatric hospitals: quality improvement initiative

[摘要] A lack of integration between internal processes andfailure to use the full potential of information technology(IT) systems is common in psychiatric hospitals. We aimedto reduce the number of out-of-hours medical errorsby ensuring that there is consistent and transparentweekend medical handover by creating an electronichandover system that is easy to use, robust and embeddedinto the existing trust IT systems. We employed qualityimprovement (QI) methodology to address this issue.After trialling in a single site followed by six cycles ofimprovement, the weekend medical handover system isnow in use across four boroughs and has been integratedinto trust policy. It has received qualitative and quantitativeevidence of improvement, with 100% of doctors reportingthe system improved patient care and a 64% (from 11to 4 events/year) reduction in moderate, severe andcatastrophic adverse incidents occurring out-of-hourswithin the older adult service (p=0.29, χ2 1.117).The increasing number of complex patients with comorbidmedical illness in psychiatric inpatient services demandsrobust handover systems similar to that of an acute trust.This QI work offers a template for achieving this acrossother psychiatric trusts and demonstrates the positivechange that can be achieved.

[学科分类] 药学