Service innovation: A comparison of two approaches for physical screening of psychiatric inpatients
Service innovation: A comparison of two approaches for physical screening of psychiatric inpatients
复制标题
DOI：
10.3109/13651501.2011.620128
复制
发表时间：
2012-06-01
影响因子：
3
通讯作者：
Dickinson, Timothy
中科院分区：
文献类型：
--
作者：
Harrison, Mark Richard;Mcmillan, Catherine Frances;Dickinson, Timothy
Objective.精神病药物与肥胖、糖尿病、血脂异常、高血压、高泌乳素血症和运动障碍有明显的联系。这些疾病是精神病患者发病和死亡的常见原因，但卫生服务部门的体检往往是随意的。方法.我们报告的审计结果的物理筛选在两个医院病房。每个病房都进行了服务改进。一个病房修改了入院表格，另一个病房建立了出院筛查诊所。然后通过对两个病房的实践进行重新审核，比较这些干预措施的有效性。结果基线时，筛选不一致且不频繁。平均而言，修改后的入院形式将筛查率提高了4.7%，而出院筛查诊所的筛查率为30.7%。出院筛查诊所显示，筛查率在统计上有显著提高，并有效提供了健康促进咨询。结论.出院筛查诊所比改进的入院程序更有可能检测到临床显著异常。如果这些异常被发现和治疗，那么精神病患者的长期身体健康可能会得到改善。
Objective. Psychiatric medications have clear links to obesity, diabetes, dyslipidaemia, hypertension, hyperprolactinaemia and movement disorders. These disorders are a common cause of morbidity and mortality in psychiatric patients but physical screening by health services is often haphazard. Methods. We report the findings of an audit of physical screening across two hospital wards. Each ward undertook a process of service improvement. One ward modified the admissions proforma and the other developed a discharge screening clinic. The effectiveness of each of these interventions was then compared through a reaudit of practice across both wards. Results. At baseline, screening was performed inconsistently and infrequently. On average, the modified admissions proforma increased screening rates by 4.7% compared to 30.7% for discharge screening clinics. The discharge screening clinic demonstrated statistically significant improvements in screening rates and effectively delivered health promotion advice. Conclusions. Discharge screening clinics are significantly more likely than improved admissions procedures to detect clinically significant abnormalities. If these abnormalities are detected and treated then the long-term physical health of psychiatric patients may be improved.