Measuring process indicators and adverse events to assess the quality of care for inpatients with psychosis

Abstract

Background

Research into the quality of care in psychiatry is scarce. Data collection is falling behind that for other fields of medicine and therefore the opportunity to improve care is missed.

Aims

In this medical record study we aim to determine: (i) whether or not patients’ physical health indicators are assessed and pharmacological and behavioural treatment interventions applied; (ii) the incidence and nature of adverse events in psychotic inpatients.

Methods

Medical records of inpatients with psychosis admitted to psychiatric wards at Amsterdam UMC, location AMC, Department of psychiatry, were screened with a previously developed and tested two-step patient safety tool.

Results

Data of 299 admissions were included. Physical health indicators were not assessed in one-third of cases. Fifty-five percent of the patients were smokers but only 1% received an intervention. The family was actively involved in 43% of the cases. During 11,403 admission days, 235 adverse events had been recorded. The most frequent adverse event was adverse drug reactions (40%), which were mostly related to antipsychotic medication.

Conclusions

In conclusion, quality of care auditing is useful to prioritize areas that need improvement. Future research should focus on interventions to improve the quality of psychiatric care.

Keywords:

• Patient safety
• psychosis
• quality of care
• quality indicators

Acknowledgement

We are very grateful for the help from Ko Hagoort in editing this manuscript. This research received no specific grant from any funding agency, commercial, or not-for-profit sectors.

Disclosure statement

No potential conflict of interest was reported by the authors.