QI: Improving Physical Healthcare Recording in a Mental Health Service for Homeless People – Working With KPI's

AIMS: As a mental health team for homeless people, we are aware of poor health outcomes for our patients. They face the double-hit of chronic serious mental illness (SMI) and homelessness, reducing life expectancy. As outlined in guidance, “secondary care team should maintain… monitoring service use...

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Autores principales: Hall, Hugh, Ward, Michael, Wicks, Georgina, Sulej, Katarzyna, Agyapongmaa, Abena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9378011/
http://dx.doi.org/10.1192/bjo.2022.298
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author Hall, Hugh
Ward, Michael
Wicks, Georgina
Sulej, Katarzyna
Agyapongmaa, Abena
author_facet Hall, Hugh
Ward, Michael
Wicks, Georgina
Sulej, Katarzyna
Agyapongmaa, Abena
author_sort Hall, Hugh
collection PubMed
description AIMS: As a mental health team for homeless people, we are aware of poor health outcomes for our patients. They face the double-hit of chronic serious mental illness (SMI) and homelessness, reducing life expectancy. As outlined in guidance, “secondary care team should maintain… monitoring service user's physical health”. We aimed to improve recorded annual physical health checks according to Trust Key Performance Indicators (KPI) for weight; hypertension; diabetes; cholesterol; and screening for smoking, drugs and alcohol on SystmOne (e-patient record) in Westminster's Joint Homelessness Team's (JHT) caseload, with target of 90% by December 2021 set by Central and North West London (CNWL) NHS Trust. METHODS: Using monthly physical health KPI reports to target uncompleted annual health checks for JHT's 135 patients. PDSA cycles were used over a six-month period from July 2021 – January 2022. Intervention 1: Using available GP data to pull across into our records, making use of existing information. Intervention 2: Dedicated clinical session from FY2 doctor to assess patients with missing physical health checks. Intervention 3: Specific teaching to whole MDT to increase awareness and uptake. Intervention 4: Designed our own reporting to give real-time rather than monthly reporting. Outcomes were measured from monthly Physical Health reports for the active caseload. RESULTS: At baseline only 26.67% of patients had completed recorded health checks. Intervention 1 more than doubled our recordings to 54.17% over a 2-month period. Our second intervention further improved recorded physical health checks. The third intervention increased our recorded physical health checks to 82.35% over a 2-month period. Notably, at the beginning of our project 7 out of 135 patients, had no engagement in physical health check monitoring, this reduced to 1 after intervention 3. At the end of our fourth cycle, we had increased our recorded physical health checks to 83.93%. Overall, results show an improvement of 57.26%, or a relative increase of 3.15 times the amount of recorded physical health checks over 6 months. CONCLUSION: As a result of incorporating dedicated clinical time, teaching and real-time use of data, we have improved our recorded physical health checks. There is room for improvement with 16% of patients still with incomplete health checks and approximately 10% of patients without blood tests. Some of this is due to accessibility and engagement difficulties for people with SMI and entrenched rough-sleeping, with ongoing work being done.
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spelling pubmed-93780112022-08-18 QI: Improving Physical Healthcare Recording in a Mental Health Service for Homeless People – Working With KPI's Hall, Hugh Ward, Michael Wicks, Georgina Sulej, Katarzyna Agyapongmaa, Abena BJPsych Open Quality Improvement AIMS: As a mental health team for homeless people, we are aware of poor health outcomes for our patients. They face the double-hit of chronic serious mental illness (SMI) and homelessness, reducing life expectancy. As outlined in guidance, “secondary care team should maintain… monitoring service user's physical health”. We aimed to improve recorded annual physical health checks according to Trust Key Performance Indicators (KPI) for weight; hypertension; diabetes; cholesterol; and screening for smoking, drugs and alcohol on SystmOne (e-patient record) in Westminster's Joint Homelessness Team's (JHT) caseload, with target of 90% by December 2021 set by Central and North West London (CNWL) NHS Trust. METHODS: Using monthly physical health KPI reports to target uncompleted annual health checks for JHT's 135 patients. PDSA cycles were used over a six-month period from July 2021 – January 2022. Intervention 1: Using available GP data to pull across into our records, making use of existing information. Intervention 2: Dedicated clinical session from FY2 doctor to assess patients with missing physical health checks. Intervention 3: Specific teaching to whole MDT to increase awareness and uptake. Intervention 4: Designed our own reporting to give real-time rather than monthly reporting. Outcomes were measured from monthly Physical Health reports for the active caseload. RESULTS: At baseline only 26.67% of patients had completed recorded health checks. Intervention 1 more than doubled our recordings to 54.17% over a 2-month period. Our second intervention further improved recorded physical health checks. The third intervention increased our recorded physical health checks to 82.35% over a 2-month period. Notably, at the beginning of our project 7 out of 135 patients, had no engagement in physical health check monitoring, this reduced to 1 after intervention 3. At the end of our fourth cycle, we had increased our recorded physical health checks to 83.93%. Overall, results show an improvement of 57.26%, or a relative increase of 3.15 times the amount of recorded physical health checks over 6 months. CONCLUSION: As a result of incorporating dedicated clinical time, teaching and real-time use of data, we have improved our recorded physical health checks. There is room for improvement with 16% of patients still with incomplete health checks and approximately 10% of patients without blood tests. Some of this is due to accessibility and engagement difficulties for people with SMI and entrenched rough-sleeping, with ongoing work being done. Cambridge University Press 2022-06-20 /pmc/articles/PMC9378011/ http://dx.doi.org/10.1192/bjo.2022.298 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Quality Improvement
Hall, Hugh
Ward, Michael
Wicks, Georgina
Sulej, Katarzyna
Agyapongmaa, Abena
QI: Improving Physical Healthcare Recording in a Mental Health Service for Homeless People – Working With KPI's
title QI: Improving Physical Healthcare Recording in a Mental Health Service for Homeless People – Working With KPI's
title_full QI: Improving Physical Healthcare Recording in a Mental Health Service for Homeless People – Working With KPI's
title_fullStr QI: Improving Physical Healthcare Recording in a Mental Health Service for Homeless People – Working With KPI's
title_full_unstemmed QI: Improving Physical Healthcare Recording in a Mental Health Service for Homeless People – Working With KPI's
title_short QI: Improving Physical Healthcare Recording in a Mental Health Service for Homeless People – Working With KPI's
title_sort qi: improving physical healthcare recording in a mental health service for homeless people – working with kpi's
topic Quality Improvement
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9378011/
http://dx.doi.org/10.1192/bjo.2022.298
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