bluuebunny/crossref_metadata_2025_split huggingface dataset:
Making It PEACHY: Creation of an Innovative Immersive Simulation Day Promoting Empathetic, Attentive Communication for Holistic Care for Year 4 Medical Students
Authors: Mishra Vatsala , Elankovan Archanaa , Winston Ian 
Published: August 2024

AimsThis team of simulation fellows and a final-year medical student at a London teaching hospital created an innovative simulation course for fourth-year medical students with the aim to supplement existing undergraduate psychiatry teaching by providing additional opportunity to practice clinical skills. The course allowed students to practice and improve advanced communication skills across a range of inpatient and community settings across GP, A&E, medical and psychiatric environments, with themes exploring psychiatry, heightened emotional states and biopsychosocial influences on mental and physical health in a safe, ethical manner, supplementing the teaching provided on clinical placements.MethodsThe course was fully mapped to the university curriculum as well as the Health Education England Future Doctor Vision and the Medical Licensing Assessment content map. Scenarios were written by trained simulation faculty in conjunction with specialty experts across all core specialties for fourth year medical students including obstetrics and gynaecology, paediatrics, psychiatry, and healthcare of the elderly. Scenarios were created to reflect local demographics with addition of detailed social history and population health information. This involved creation of simulated patients from multicultural backgrounds, with limited English or other communication needs, and representation of numerous gender expressions, sexual orientations, and a range of mental health and neurodevelopmental needs.ResultsThe pilot course took place on May 2nd with 7 student participants following approval from senior education stakeholders. During debriefs, participants differentiated between psychiatric symptoms and non-pathological human experiences, and reflected on how and why the patient in front of them is presenting the way that they are, with regards to social determinants of physical and mental health. They were also guided to reflect upon the technical and non-technical learning objectives of each scenario including use of Crisis Resource Management principles. Quantitative and qualitative feedback was collected through use of Likert-scales and white space questions; feedback showed heightened confidence and competence in core skills including psychiatric history taking, mental state examination and risk assessment, as well as core communication skills such as explaining a new diagnosis and managing heightened emotion.ConclusionFeedback shows the pilot successfully met its aims and enhanced undergraduate training, filling an educational need. Next steps would include formally approaching the university to discuss implementation of the course into the core curriculum. Additional refinements would include further consultation with service users and people with lived experience and consideration around use of actors to ensure complex subjects such as immigration and neurodivergence are portrayed ethically and accurately.
Physical Issues in Mental Health Settings – Implementation of a New Immersive Course for Core Psychiatry Trainees
Authors: Mishra Vatsala , Winston Ian 
Published: August 2024

AimsThis team of simulation fellows at a London teaching hospital created an immersive simulation course for core psychiatry trainees to explore the intersection between physical and mental health and impact on provision of care. The course was fully mapped to the updated Royal College Core Training Curriculum as well as Crisis Resource Management principles, and focusses on the integration of care across mental and physical health provisions. Scenarios are set in a range of inpatient and community environments to allow participants to consider differences in delivery of holistic care, prioritisation, ethical and legal considerations across settings. This would be particularly relevant for participants early in training with limited prior exposure who may be unfamiliar with handling emergencies on psychiatric wards and the nuanced limitations in providing medical care.MethodsScenarios were written in consultation with speciality experts and allied health professionals including mental health nursing, dietetics, and pharmacy. The course is written to enable participants to explore the intersection between physical and mental health, and the practical and social implications of an individual's mental and physical condition on provision of care. Alongside debriefing technical and non-technical learning objectives, participants reflected upon the wider determinants of each patient's current physical and mental state and discussed ethicolegal considerations such as patients’ legal status, capacity to consent, and practicalities of transferring patients between services and facilitating holistic care.ResultsThe pilot course took place on July 4th following consultation with stakeholders including senior simulation and education leads within the Trust, and deanery Training Programme Directors, to ensure the course was formally endorsed to allow participants to apply for study leave to attend. Post-course feedback was collected through use of Likert-scales and white space questions; the response was highly positive and showed the programme met its aims and filled a training need. Feedback showed increased confidence managing integrated physical and mental health issues and balancing conflicting priorities with increased understanding of practical and social implications of mental and physical condition on provision of care.ConclusionNext steps involve collaboration with service users to allow accurate representation of the unique needs of a diverse population, and potential use of actors to sensitively and ethically portray simulated patients. Local psychiatry training schools could be approached to consider formal implementation of the course within academic programmes, in addition to potential reformulation of scenarios for use in established courses at the host site such as Undergraduate or Foundation training days.
Live the Experience: Mental Health Simulation Training for New Starters to Psychiatry in East London NHS Foundation Trust (ELFT)
Authors: Patel Alisha , Ismail Haitham , Valdearenas Lorena 
Published: August 2024

AimsThis project aimed to create and deliver a simulation-based course to improve trainees’ knowledge, practical skills and confidence as well as leadership and multidisciplinary-team working. We evaluated the effectiveness of this training and simulation as a learning experience. Simulation in psychiatry is a relatively new field compared with other specialities. Literature shows that experiential learning in psychiatry is effective for developing clinical and communication skills for doctors, and confidence in leadership. It is vital we work towards the National Health Service Long Term Plan for improving mental health care for those with serious mental illness which includes better training for doctors. This course was designed to enhance the ELFT training programme focusing on applications of theoretical knowledge.MethodsA simulation-based course was delivered to core trainees and general practitioner trainees at induction to psychiatry. This was based on the Royal College of Psychiatrists curriculum and input from our People Participation team to ensure authenticity of scenarios. We surveyed trainees to inform the development of our pilot in February 2022 and subsequently developed two half-day courses facilitated in August 2022 following feedback. The scenarios we created were: risk assessment, section 5(2) Mental Health Act (MHA) assessment, managing agitation and violence, escalating concerns to a senior, section 136 MHA assessment, seclusion review, discussion with medical registrar for physical health concerns, collateral history and information-giving in child psychiatry. We used a structured debrief model (what went well, what could you have done differently, what was the ‘golden moment'?) and provided relevant teaching. Service users joined the debrief to share their perspectives and lived experiences. We collected and analysed quantitative and qualitative feedback.ResultsTen trainees attended the pilot course, followed by eleven on day 1 and nine on day 2 in August 2022. Results from questionnaires revealed post-course, 100% of participants felt more confident in their psychiatric skills and found this experience to be valuable for clinical practice. 100% would recommend this simulation to others. Qualitative data showed participants thought scenarios were realistic, the environment was supportive and feedback was comprehensive. They also appreciated the service user involvement.ConclusionTrainees reported simulation provided a safe and engaging environment to learn practical skills which better prepared them for work. This course is now embedded into the ELFT induction programme and enables doctors to develop their confidence and have a better understanding of service user perspectives. Future development of this course will involve allied health professionals.
Tailored CAMHS Educational Sessions for Primary Care Staff
Authors: Sherratt Anna , Foster Michael 
Published: August 2024

AimsTo develop and evaluate a tailored teaching session for local non-medical primary care staff on common CAMHS (Child and Adolescent Mental Health) conditions. It was hypothesised that quizzes administered before and after the educational session would evidence an improvement in clinician's knowledge of these clinical presentations.MethodsInvitations were extended to all local PCNs to attend educational sessions held on four separate occasions in December 2022 and January 2023. Multiple choice quizzes were administered before and after a presentation on four common CAMHS conditions. The presentation and quizzes covered the presentation, diagnosis, and management of autism, eating disorders, depression and emotional dysregulation. Quizzes were scored out of a maximum 16 points with four questions per clinical condition. A paired T-test (following tests for normal variance) was performed using JASP software to compare the before and after scores.ResultsA total of 22 non-medical clinical staff attended the sessions. This included physician associates (n = 1), allied health professionals (n = 5), practice nurse (n = 3), care coordinator (n = 3), health care assistant (n = 4), social prescriber (n = 1), mental health practitioner (n = 3), advanced clinical practitioner (n = 1) and advanced nurse practitioner (n = 1). For the 22 pairs of quizzes, mean differences and 95% confidence intervals (CIs) were calculated between before-and-after scores. The mean difference between total score was 6.9 CI [6.1, 7.7] which was statistically significant (p < 0.001).ConclusionMore than 31,000 additional staff have been recruited into healthcare roles at general practices across the country since 2019 to meet soaring demand for primary care services. Since the pandemic record numbers of children and adolescents are presenting with mental health difficulties, therefore, it is likely that primary care clinicians will encounter these presentations in their practice. Our results suggest that such a tailored approach can offer effective means in improving knowledge in this growing group of professionals. Such sessions may also provide informal spaces in which to network with secondary mental health professionals, improving links between services.
Developing an Electronic Handover System for On-Call Doctors in a South London Mental Health Trust
Authors: Abdelsamie Ahmed , Alexander Laith , Wilkinson Rebecca , Dawson Olivia , Yadav Prateek 
Published: August 2024

AimsTo replace pre-existing paper-based and informal handover systems with a confidential electronic handover system for on-call doctors across a large South London mental health trust, thereby improving the safety and quality of handovers.MethodsA quality improvement project was registered within our trust. At baseline, we surveyed core trainees, GP trainees, and locum doctors about their experiences using a paper handover system for on-calls at the Bethlem Royal Hospital and Lambeth Hospital, South London and the Maudsley NHS Foundation Trust (SLaM). Their feedback guided the implantation of a confidential and secure electronic handover system integrated into the trust's Microsoft SharePoint, using the Microsoft To Do app and then Microsoft Teams. We alerted doctors to these changes via formal and informal means, such as trust inductions, emails and through communication with trust junior doctor representatives. After a period of 8 and 24 weeks, we assessed the initiative's success by collecting both qualitative and quantitative data from on-call doctors about their experience with the handover system. Based on feedback, we made multiple adjustments to improve the system, which was later adopted at Lambeth Hospital. The Microsoft To Do app was then replaced by a channel on Microsoft Teams to ensure wider access.Results15 doctors responded to the baseline survey. Handover practices were varied and included paper-based handovers, phone calls, and emails. Mean doctors’ ratings for the pre-existing handover systems were 3.2/5 for overall quality (1: very poor; 5: very good) and 2.7/5 for safety (1: very unsafe; 5: very safe). 60% (n = 9) of doctors said tasks would sometimes be missed in the pre-existing handover system. 21 doctors responded to 2 post-change surveys. Mean doctors’ ratings of overall quality were 4.6/5 and safety were 4.5/5. Qualitative feedback highlighted that a verbal handover was still necessary to complement the electronic system, and that locum doctors would need to have access to the system as well as consultants and registrars during periods of industrial action.ConclusionAn electronic handover system was successfully implemented to replace a predominantly paper-based handover system at two large mental health hospitals in South London, and on-call doctors reported improvements in handover safety and handover quality. Future work aims to implement a consistent electronic handover system across other hospitals in SLaM and other trusts and transition fully to Microsoft Teams for broader accessibility.
Enhancing Well-Being: Optimizing Service Delivery in Neighbourhood Mental Health Team (NMHT) for Administrative Staff and Service users
Authors: Ali Harith , Moller Danica , Selim Amra , Meah Taz , Ali Selma 
Published: August 2024

AimsPromoting the well-being of staff is paramount within mental health services. However, a common issue arises where administrative personnel, often serving as the primary point of contact for service users, engage in mental health-related interactions without formal training. This deficiency can adversely affect their well-being, leading to diminished team morale and increased staff turnover, consequently impacting the quality of care provided by the Neighborhood Mental Health Team (NMHT). Moreover, it can contribute to dissatisfaction among service users, jeopardizing their rapport with the service. We aim to improve the wellbeing of staff and service users and to optimize service delivery at the local NMHT.MethodsData were gathered from a local NMHT catering to 1200 service users in the borough of Tower Hamlets in London. A pre- and post-implementation questionnaire was administered to both service users and six administrative staff members. The questionnaire highlighted several areas for improvement, including a lack of mental health understanding among administrative staff, reported low confidence when handling certain phone inquiries, and service user complaints. Change initiatives were then devised to address these concerns and evaluate their impact on enhancing the experience for both service users and administrative staff.ResultsAdministrative staff uniformly expressed the need for increased mental health training prior to commencing their roles. Implementation of targeted change initiatives led to noticeable improvements in service user satisfaction and staff confidence in managing phone interactions. These enhancements culminated in an overall advancement in service delivery.ConclusionThrough the strategic implementation of change initiatives informed by our initial findings, we not only augmented mental health literacy among administrative staff and service users but also bolstered their well-being. Consequently, this directly translated into an amelioration of local service offerings. Further research is warranted to ascertain the long-term efficacy of these innovative interventions.
Improving Quality of Multidisciplinary Team Meetings in Our Community Mental Health Team in NHS Greater Glasgow and Clyde, Scotland
Authors: Ambardar Prerna , Brown Rachel 
Published: August 2024

AimsTo ensure smooth running of Multidisciplinary team (MDT) in Community mental health team (CMHT) and reviewing MDT structure for better functioning at Parkview Mental health Resource centre.On a Friday two Multidisciplinary teams (MDTs) were running online on Microsoft teams simultaneously. The same staff was running the two MDTs, so staff input could be limited at times and staff would dip in and out of MDTs. Discussion around ways of improving this so that both MDTs run smoothly. Also, there was no formal structure to MDT meetings. It was decided that improvement in Quality of MDT needs to be addressed.MethodsInitially numerous discussions held online with Parkview team, nursing colleagues.CMHT Quality improvement group was set up and a meeting was arranged where everyone's ideas were considered.A pilot project was first introduced in March 2022 and audited in July 2022. Plan, do, study, act (PDSA) cycle was carried out.PlanTwo nursing teams to be setup which will feed back into the two MDTs on alternate weeks. This will reduce nursing teams having to come in and out of one MDT to join other MDT, hence increasing the efficacy of the MDT.Devise a new template to provide formal structure for the MDT presentation.DoTrial the new setup of two nursing teams.StudyAsk all MDT staff members for feedback on the working of MDT.ActReformat the Structured template and distribute to all staff members.Results100% staff felt that new structure of MDT was useful.84% staff satisfied with the new way of running of MDT.84% staff satisfied with having designated teams for MDT.ConclusionHaving Designated MDT teams and a structured format helped in robust functioning of the MDT in the CMHT.
Improving Trainee Doctors' Awareness on How to Refer for Routine Radiological and Cardiac Investigations at a Psychiatric Hospital in South London
Authors: Felton Annabel , Ang Trisha 
Published: August 2024

AimsPsychiatric inpatient hospital, although part of secondary care, is separate from a physical health hospital and therefore does not have access to electronic referral systems, which increases efficiency of referral processes. As part of an admission clerking for all inpatients in psychiatric hospitals, the admitting doctor takes a history of past medical issues, a physical examination, electrocardiogram and bloods. Depending on findings, further radiological and cardiac investigations may be warranted. Not having access to electronic referral systems can cause delay in delivering treatment for psychiatric inpatients, especially when referral pathways is unclear. The aim of this quality improvement project is to increase the knowledge of referrers in order to improve efficiency completing referrals and reduce incorrect referrals. With clinicians able to refer for routine imaging correctly and in an efficient manner, it is hoped that this will correlate with an improved quality of care received by patients.MethodsFirstly we assessed the knowledge of currently employed trainee doctors, via a web-based survey, on how to refer for routine and commonly ordered radiological and cardiac investigations. Employed referrers included core trainee, GP and foundation year trainee doctors. We then created an electronic referral pack which includes a guidance and referral forms provided to clinicians when they start employment at Lambeth hospital and accessible to current trainees. A follow up survey then reassessed the knowledge of these referrers.ResultsThere was a total of 11 responses received from survey prior to sending out the electronic referral guidance pack, of which 100% believed that it would be helpful to have a referral guidance pack. A total of 4 responses were received after sending out the guidance. The surveys showed that there is improved knowledge of how to refer for routine radiological and cardiac investigations after guidance was sent. Prior to sending the guidance, 9.1% referrers were made aware of the referral process, and this increased to 50% after the referral guidance pack was sent out.ConclusionTrainee doctors in psychiatric hospitals require more support with physical health management in psychiatric hospitals, including referring for physical health investigations, as referrers cannot access electronic referral systems used in physical health hospitals. Results need to be correlated with clinical outcomes in future. A longer term project could include linking the electronic referral systems between psychiatric and physical health hospitals.
Adherence to RCPsych Standards for Physical Health Monitoring and Health Promotion in Patients Open to the North Wales Early Intervention Psychosis (EIP) Service
Authors: Azhar Zeenish , Mendieta Javier 
Published: August 2024

Aims•The audit aims to improve the quality of physical health monitoring and physical health interventions that the EIP service provides to people with psychosis.•To ensure adherence to RCPsych standards for physical health monitoring in patients with First Episode Psychosis.•To ensure adherence to RCPsych standards for provision of required physical health interventions and health promotion in patients with First Episode Psychosis.Methods•A retrospective case note audit and re-audit was conducted for 13 patients on the caseload of the North Wales EIP service from December 2022 to December 2023.•The case notes were audited against RCPsych standards for physical health monitoring and physical health interventions using an adapted version of the National Clinical Audit of Psychosis (NCAP) audit tool.Results•Alcohol and substance misuse screening status improved to 100% in re-audit.•There was significant improvement noted in Hypertension, Body Mass Index and Cholesterol screening.•Mental health medication review, advice or referral for diet and exercise with regards to weight gain/obesity and hypertension improved to 100%.•No specialist interventions were offered around health promotion and illness prevention as most of the patients were either not in the abnormal range, identified as high risk for developing the above mentioned physical health conditions or refused to have interventions for these conditions.•A definite increase was observed in frequency of interventions being reviewed and reoffered for those accepting and declining interventions at baseline.Conclusion•Training for staff to complete bloods and physical health screening.•Increase availability of equipment to carry out physical health screening.•Monthly, three and six monthly prompts in the case notes for staff to discuss physical health interventions with patients.•Staff to use headings for physical health screening and interventions to improve documentation in case notes.