How can digital technology make inpatient psychiatry units safer?
Patient safety is a priority for all psychiatric units. Patients must be rounded upon every 15 minutes; and those judged at high risk must be rounded upon every 5 minutes. The current paper record only records a checkbox to indicate that the patient was checked some time in the 15 minute (or 5 minute) time block; if a patient was checked at the start of one 15 minute period and then again at the end of the next 15 minute period, a total of nearly 30 minutes could elapse. In addition patients have to sign out potentially dangerous items such as a razor or an electronic cord. Those items are signed out on a paper sheet and signed back in, but it is only at the end of shift that a Resource Nurse makes sure all items are reconciled. These two paper systems (the patient checks and the item sign out ) create a significant safety risk. In addition, paper records do not allow meaningful data analysis and require storage.
The aim of this quality improvement project was to develop an app that would serve as an electronic rounding tool by which a mental health associate making rounds would get electronic reminders when patients were due to bechecked, that would record the actual time a patient was seen. The system could also capture unified data in a standardized manner to enable future quality improvement and patient safety projects.
The safety checks app syncs with the online medical record to ensure all patients admitted to the inpatient unit show up on the app. Staff members use the app to conduct real time safety checks and enter data every 5 or 15 minutes depending on clinical needs.
Data from the safety checks app offer a unique opportunity to analyze how the space and environment of inpatient psychiatric units promotes recovery. The data can also be used to track care and help improve patient safety.
We are currently piloting the safety checks apps on the inpatient unit. With further testing, the app may be available to other hospitals and units in the near future.