Clinical Re-Audit of the Interface Between Community and Inpatient Management of Service Users

AIMS: The working interface between inpatient and community mental health teams can ensure a smooth and safe transition for service users following admission to the hospital. It is the first opportunity to reassess this aspect of service after the pandemic as the original audit was done before the lockdown. To follow up on amber results and to identify if the data captured from the previous audit has improved. This clinical audit project also reviewed how often community mental health teams and service users met during a patient's inpatient stay. METHODS: The audit was conducted at West Park Hospital, Darlington. Information was collated from a consecutive group of female inpatients that were discharged from Elm Ward between 01/02/2021 and 23/03/2021. The audit data collection was performed between 01/05/2021 and 31/05/2021. Data were collected retrospectively and was obtained from the inpatient medical records system (PARIS), and input into a designated audit tool. Medical records were reviewed for the duration of each inpatient episode, and the criteria and standards above were applied. RESULTS: The data demonstrate that in the vast majority of cases, the ward invited the community team to the relevant meetings during the patient admission (96%) which indicates the improvement in compliance with virtual meetings. In 100% of cases, there were contacts between the community team through MS Teams or directly through phone or face to face (the number of contacts depends on the length of admission, shown in the figure below). The percentage of patients that were offered a written copy of the care plan was observed to have increased when this is compared to the original Audit. The percentage of patients whose GP doctor was informed also increased to 20%, however, that is still at red remarks. CONCLUSION: An amber compliance rating was assigned to this clinical audit report. High compliance was achieved for evidence of the reason for admission, anticipated risks, and capacity communicated to the ward by the care coordinator/crisis team. There is evidence of inviting the care coordinator/crisis team staff to the initial formulation meeting and review/MDT meetings. However, some elements of the Admission, Transfer, and Discharge policy required improvements, particularly in relation to information about expected length of stay communicated to the ward by care coordinators/crisis team staff. It should be clear who should be responsible to inform the patient's GP within 24 hours of admission. Still, compliance with offering patients a written copy of the care plan (care document/ intervention plan), is low.