Impact of a peer-review network on the quality of inpatient low secure mental health services: cluster randomised control trial.

Background: Peer-review networks aim to help services to improve the quality of care they provide, however, there is very little evidence about their impact. We conducted a cluster randomized controlled trial of a peer-review quality network for low-secure mental health services to examine the impact of network membership on the process and outcomes of care over a 12 month period.

Methods: Thirty-eight low secure units were randomly allocated to either the active intervention (participation in the network n = 18) or the control arm (delayed participation in the network n = 20).

Impact of peer-led quality improvement networks on quality of inpatient mental health care: study protocol for a cluster randomized controlled trial.

Background: Quality improvement networks are peer-led programmes in which members of the network assess the quality of care colleagues provide according to agreed standards of practice. These networks aim to help members identify areas of service provision that could be improved and share good practice. Despite the widespread use of peer-led quality improvement networks, there is very little information about their impact.

Does sustained involvement in a quality network lead to improved performance?

Purpose: The purpose of this paper is to explore the effects of prolonged investment in one quality improvement method, which are uncertain. The authors aim to examine the extent to which sustained involvement in a quality network over five years led to improved performance against standards, and whether improvement was achieved in areas where service staff could exercise direct control.

Design/methodology/approach: A prospective cohort design was used to examine data from 48 UK inpatient child and adolescent mental health units between 2005/2006 and 2009/2010, which had been Quality Network for In-patient CAMHS members for two years.

Three decades of quality improvement in electroconvulsive therapy: exploring the role of accreditation.

Objectives: This study aims to track electroconvulsive therapy (ECT) clinics' compliance with standards for the administration of ECT before and after the introduction of the Electroconvulsive Therapy Accreditation Service (ECTAS) in 2003.

Methods: Three audits on the practice of ECT were retrospectively analyzed, and ECTAS data from 2004 to 2011 were prospectively analyzed. Overall compliance with 10 ECT audit standards was presented in 2 ways: annually and for each of the 3 waves of accreditation.

The service context for clinical guidelines: supporting guideline implementation by assuring and improving the quality of service in which clinicians work.

This paper argues that accreditation schemes and quality networks promote good contexts for the implementation of clinical guidelines. It raises questions about how organizational standards should be developed, structured and focused, how clinical guidelines and organizational standards should connect, how to practically increase the number of such schemes and their scope, and the role of professional bodies in this. There is a considerable amount of administration involved in running an accreditation scheme or quality network and there are risks involved in starting in new areas.

Cost and impact of a quality improvement programme in mental health services.

Objective: To estimate the cost and impact of a centrally-driven quality improvement initiative in four UK mental health communities.

Methods: Total costs in year 1 were identified using documentation, a staff survey, semi-structured interviews and discussion groups. Few outcome data were collected within the programme so thematic analysis was used to identify the programme's impact within its five broad underlying principles.

Electroconvulsive therapy: the practice and training needs of referring psychiatrists in the United Kingdom and Republic of Ireland.

This study aims to gain a greater understanding of the clinical practice and training needs of psychiatrists who prescribe electroconvulsive therapy (ECT), including knowledge about ECT, obtaining informed consent, and the monitoring of patients after ECT. Four hundred ninety psychiatrists who refer patients for ECT were sent questionnaires as part of reviews conducted by the ECT Accreditation Service, and 56% responded. Data were analyzed using descriptive statistics and thematic analysis.

The Staffing of Inpatient Child and Adolescent Mental Health Services.

Background:   There is a need for more accurate information regarding the staffing of Child and Adolescent Psychiatric inpatient units. This is both to facilitate clinical governance and to allow planning and focused further development of these services.

Method:   Postal surveys were sent to all units in England and Wales.

Distribution and characteristics of in-patient child and adolescent mental health services in England and Wales.

Background: Little is known about the current state of provision of child and adolescent mental health service in-patient units in the UK.

Aims: To describe the full number, distribution and key characteristics of child and adolescent psychiatric in-patient units in England and Wales.

Method: Following identification of units, data were collected by a postal general survey with telephone follow-up.

Characteristics of the Detained and Informal Child and Adolescent Psychiatric In-Patient Populations.

Background: This project surveyed the use of the Children Act and the Mental Health Act in in-patient child and adolescent mental health services in England and Wales.

Methods: Data were collected as a day census from child and adolescent psychiatric inpatient units, questionnaire forms completed by consultant psychiatrists or key-workers. Returns were received from 71 of the 80 units.