+ Adult Mental Health Audit in YG Dr. Sarah Edwards Dr. Rhiannon Lewis Dr. Helen Salter BCU Audit Symposium

+ RCEM Standards 1.Patients who have self-harmed should have a risk assessment in the ED 2.Previous mental health issues should be documented in the patient’s clinical record 3.A Mental State Examination (MSE) should be recorded in the patient’s clinical record 4.The provisional diagnosis should be documented in the patient’s clinical record 5.Details of referral or follow-up arrangements should be documented in the patient’s clinical record 6.From the time of referral, a member of the mental health team will see the patient within 1 hour 7.An appropriate facility is available for the assessment of mental health patients in the ED 8.Assessment room meets all standards set by the Psychiatric Liaison Accreditation Network (PLAN)

+ This graph shows how EDs performed on all standards for this audit. ↑ Higher scores (e.g. 100%) indicate higher compliance with the standards and better performance.

2.7% OF ALL PRESENTATI ONS TO THE ED AVERAGE AGE: 36 YEARS OLD 39 10% ARE <18 YEARS SELF HARM AND MIXED OD MOST COMMON PRESENTATIONS 81% PRESENT OUT-OF-HOURS EQUAL SEX DISTRIBUTION

+ Local Issues… Documentation  Poor Illegible No documented risk assessment/what the patient was wearing or anything related to the fact they came in with a psychiatric complaint RCEM Criteria not being met

+ Improvements - MDT ED Dr. Tania Burgelli Consultant Liaison Psychiatrist Mr. Jonathan Morris – Lead nurse for Liaison Psychiatry Patient

What next? MH Aide Memoir has been implemented from August 2015 Currently re-auditing its use Overall our compliance should improve for RCEM Feedback so far has included “ Awesome, succinct and easy to use” FY2 Doctor “ Useful information for us, when reviewing patients” Liaison Psychiatric Nurse

+ Any Questions?