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Research and Audit Based on the results of the initial audit, strategies to improve performance were implemented. An e-mail was circulated to all consultants and junior doctors involved in risk assessment for adult inpatients highlighting the outcomes and raising awareness of the need for adequate risk assessment. The three questions and the need to fulfill these were documented in the e-mail along with the intent to re-audit in 2 months’ time. As the changeover for junior doctors occurred shortly after the audit, this e-mail was circulated to both those doctors completing their post and those taking over from them. Re-audit A re-audit was undertaken in May 2009. 23 sets of notes were randomly selected from all the in-patients currently on ACU (split equally across Blake and Clare wards). The 23 notes selected were then examined using the method and analysis outlined in the initial audit. Results were obtained for an overall view of the different criteria being assessed. There was no breakdown of results by consultant or regularity of ward round as this showed no impact in the initial audit. Results were analysed depending on length of stay, as this was identified as having an impact. These results were then compared with those of the initial audit to see if the heightened awareness had altered the recording of risk assessment Based on the results of the first re-audit and the possible areas of bias, further strategies to improve performance were implemented and second re-audit conducted in November 2009, which was towards the end of the post for the cohort of doctors included. The second re-audit followed the same method and structure as the earlier re-audit in May 2009. This ensured that there had been consistency in the doctors completing the documentation over the last four months and also a long enough time period to ensure no notes had been included in the previous audit cycle. Formal teaching on risk assessment was delivered to the new cohort doctors at the beginning of their post in psychiatry at the ACU, Chertsey. This included an explanation of the risk assessment form and its importance, and was conducted by one of the in-patient consultants. Results Fig.1 Initial audit – distribution overall 100 90 80 70 60 % 50 40 30 20 10 0 Criteria Initial RA Initial complete RA Regular updates RA accessible to staff Meets standard guidelines 18 Surrey and Borders Online Journal www.sabp.nhs.uk/journal
Fig. 2 Re-audit May 2009 – distribution overall 100 90 80 70 Initial RA 60 % 50 40 30 20 Initial complete RA Regular updates RA accessible to staff Meets standard guidelines 10 0 Criteria Fig. 3 Re-audit November 2009 – distribution overall 100 90 80 70 Initial RA 60 % 50 40 30 20 Initial complete RA Regular updates RA accessible to staff Meets standard guidelines 10 0 Criteria Research and Audit Surrey and Borders Online Journal www.sabp.nhs.uk/journal 19
Page 1 and 2: Issue 1 Summer 2010 Surrey and Bord
Page 3 and 4: Do you ever wonder why you agree to
Page 5 and 6: We are not so aware of the hidden f
Page 7 and 8: esorting too soon to complex statis
Page 9 and 10: Bipolar Disorder: how effective is
Page 11 and 12: Research Method The study was condu
Page 13 and 14: Screened for Hypomania Yes No Total
Page 15 and 16: In our sample the GPs screening met
Page 17: Audit of risk assessment documentat
Page 21 and 22: An evolving service - results of a
Page 23 and 24: having clinical responsibility for
Page 25 and 26: school exposure to psychiatry as an
Page 27 and 28: The measures outlined above will ho
Page 29 and 30: Interview with Fiona Edwards, Chief
Page 31 and 32: Q. Very topical to that is the appo

Here - Surrey and Borders Partnership NHS Foundation Trust

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