Recent Submissions

  • QI 86 Timely Health and Safety/RIDDOR Reporting - February to March 2019

    Wheeler, Simon; Supported by the Quality Improvement Team, Coventry and Warwickshire Partnership Trust; Wheeler, Simon; Estates and Facilities; Estates and Ancillary; Coventry and Warwickshire Partnership NHS Trust (Coventry and Warwickshire Partnership NHS Trust, 2024)
    Aim: To review and revise the process of Health and Safety (H&S) investigation, RIDDOR identification and reporting to the Health and Safety Executive (HSE) to meet the legal requirements. On 30 January 2019 the HSE formally contacted the Head of H&S to raise concerns over the timeliness of RIDDOR reporting. The RIDDOR regulation requires that work related ‘specified’ injuries are reported in 10 calendar days and work related injuries that result in an over 7 day absence are reported in 15 calendar days. HSE communication initiated a focussed review of the H&S investigation process and RIDDOR reporting arrangements. Facilitated process mapping session identified: • delays in receiving incident reports as these were only sent following manager sign off • delays in incident reports being reviewed as this task was the responsibility of the most agile staff • delays in investigation as securing sick notes were not easily available • PDSA principles were used to quickly introduce changes Tools Used: Process Mapping which is usually undertaken with a range of people involved in the process, and enables you to create a visual picture of how the pathway currently works, capturing the reality of the process, exposing areas of duplication, waste, unhelpful variation and unnecessary steps - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-mapping-the-process.pdf. Statistical Process Control (SPC) chart, which is an analytical tool that plots data over time, showing the impact on data when changes are implemented - https://www.england.nhs.uk/statistical-process-control-tool/. Value Stream Mapping is a more detailed process map. It helps staff to understand the steps in a patient journey and the patient experience of the journey. It is used to improve their journey / pathway by eliminating steps that do not add value for them. Patients should be involved in value stream mapping - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-value-stream-mapping.pdf. Lean Transformation (Ohio’s eight wastes) approach is used to help teams examine their own workplace and eliminate activities that do not add value. This can improve patient experience and release time for frontline staff to reinvest in service provision / care giving - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-lean-ohnos-eight-wastes.pdf. Project Impact: Timely reporting of RIDDOR incidents has reduced the risk to the organisation of HSE intervention, improved the grip of H&S related incidents and investigation workflow, created a timely response to incidents which will improve staff experience of H&S investigations and created a timely identification of H&S risks and resultant actions to prevent reoccurrence.
  • Hyperprolactinaemia in the context of psychiatry

    Collier, Karen; Fynes-Clinton, Sarah; Harmer, David; Kumar, Manoj; Romain, Karen; Fynes-Clinton, Sarah; Harmer, David; Psychiatry; Medical and Dental; Coventry and Warwickshire Partnership Trust; Institute for Mind and Brain in Kerala; Keele University Medical School; Midlands Partnership NHS Foundation Trust (Cambridge University Press, 2020-06-11)
    Advocating for good physical healthcare for their patients is of the utmost importance to psychiatrists. This narrative review focuses on one part of this large goal, the topic of hyperprolactinaemia from the perspective of mental healthcare. For psychiatrists this often includes managing raised prolactin levels in the context of medication. However, they must consider the wider differentials of a raised prolactin level and the possible impact of treatments. For that reason, in this review we start with an overview of prolactin physiology before considering hyperprolactinaemia both in the context of antipsychotic therapy and its wider differentials, including prolactinoma. Investigation and management are considered and key practice points developed.