Dean's Grand Rounds

What is a Grand Round? 

  • A Faculty will pair up with a Division or Devolved Nation to examine a question relevant to their area, and deliver a free webinar 
  • The session will start with a problem/question/opportunity for change (this could be presented through a patient story) and followed by evidence and current practice
  • The webinar will discuss how we bridge that evidence-practice gap using a quality improvement approach
  • Trainees come forward and present in the Grand Rounds on behalf of their division/faculty and lead a change project focusing on this problem 
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Aims

The Grand Rounds aim to:

  • narrow the gap between education and practice
  • empower clinicians to explore datasets that inform the impact of the evidence-practice gap on their communities of practice
  • embed lived experience in clinical education
  • learn how QI methodologies can be used to narrow gap between evidence and practice.

Each webinar will feature a person or community organisation (named individual) with lived experience; Academic or Clinician presenting evidence; Medical Manager- CD/MD/Public Health professional presenting contextual data and ensuring that attendees are signposted to appropriate datasets; and, QI Lead who will help in adopting a systematic QI approach to addressing this problem and offer QI support for a maximum of six months.

Select a topic below to watch the webinars and access resources

Challenging behaviours (also known as behaviours of concern) in people with intellectual disability (ID) have a wide ranging impact on health, quality of life and wellbeing. Interventions to improve outcomes for people with challenging behaviours require a multi-disciplinary approach, and modifying practice requires political and cultural shift.

Over the past decade novel approaches have been implemented internationally with promising improvements in outcomes. ID specialist psychiatrists have long been involved in the management of challenging behaviours, and sharing experience between the RCPsych ID faculty and the Western Pacific Division will provide an important bridge to ensure psychiatrists are up to date with the latest developments.

Challenging behaviours in people with intellectual disability:

How can psychiatrists improve outcomes for people with intellectual disability and challenging behaviour?

How should psychiatrists successfully advocate to impact policy and instigate change?

This grand round focused on multiple long-term condition which is one of the major challenges that we are facing today. One in three patients admitted to hospital as an emergency has five or more health conditions which is a significant increase from a decade ago when it was one in ten. Multi-morbidity that include a mental health condition has been less studied and explored. 

Although the context of the presentation is on people with intellectual disability, the challenges related to multi-morbidity is relevant for all mental health professionals.

The grand round started with a presentation by an expert by experience and then explored the evidence base for the management, population level challenges as well as discussion of a currently ongoing research project on multi-morbidity which uses artificial intelligence in improving our knowledge and management of these conditions. 

This webinar took place on Zoom from 4.00pm-5.30pm on Thursday 30 November 2023.

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Overview

Mental health services for the elderly are not readily available in many developing countries, and there is a shortage of geriatric psychiatrists. This is a growing concern as the number of ageing people in these countries is increasing, and non-communicable risk factors associated with dementia, such as diabetes, uncontrolled hypertension, and obesity, are on the rise. Although general psychiatrists, neurologists and family physicians are available, their numbers are small, and they cannot provide comprehensive care for patients with dementia. In this regard, primary care services are better placed to deliver dementia services in low- and middle-income countries. The primary care workforce, including general practitioners and nurses, can be trained to offer holistic care for dementia patients and refer them to psychiatrists. This task-shifting is necessary to triage, treat, and address co-morbid medical and psychiatric disorders among patients with dementia. Moreover, it can provide links to community public health services to reduce risk factors, raise awareness and help communities to take care of patients with dementia.

In collaboration with the World Network of Psychiatric Trainees.

Speakers

  • Dr Djibril Moussa MD Msc, Atlantic fellow in global brain health, memory and aging center, department of neurology, UCSF, San Francisco, USA Department of psychiatry, Borama Hospital, Borama, Somaliland.
  • Dr Chandrima Naskar, Associate Specialist, Psychiatry, Tata Main Hospital; Assistant Professor, Department of Psychiatry, Manipal Tata Medical College, Jamshedpur, India.
  • Dr Margaret Isioma, Consultant Psychiatrist, Jos University Teaching Hospital, Plateau State, Nigeria.
  • Co-chair - Dr Victor Pereira-Sanchez, MD, PhD, Director of Global Fellowships, Stavros Niarchos Foundation Global Center for Child and Adolescent Mental Health at the Child Mind Institute.
  • Co-chair - Dr Sanya Virani, Assistant Professor, Associate Programme Director- Addiction Psychiatry Fellowship, Department d Psychiatry, University of Massachusetts, USA.

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Overview

The webinar aimed to offer the opportunity to present a case of severe catatonia in an intensive care unit with a rapid and complete response to ECT, and to incorporate the service user's views. The webinar hoped to provide delegates with an European overview of the awareness and knowledge of catatonia among psychiatrists, a review of the literature of ECT as treatment for psychiatric conditions including catatonia, and to also discuss current attitudes towards ECT.

Programme

  1. Introduction and welcome to the webinar
  2. 'Patient experience/ Case presentation' - Dr Myles Doyle
  3. 'Awareness and knowledge of catatonia and how to recognise it among psychiatrists' - Professor Gabor Gazdag
  4. 'National UK data in usage and outcomes of ECT for catatonia' - Professor Linda Van Diermen
  5. 'Attitudes towards ECT in Norway and current trends and updates on ECT' - Dr Eivind Aakhus
  6. Q&A

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The second webinar in our series of free #DeansGrandRounds webinars was titled 'Memory Clinics: Where are we with timely, accurate diagnoses? Are we ready for emerging new treatments in Dementia?' and took place on Thursday 24 November 2022.

The Faculty of Old Age Psychiatry and the Northern and Yorkshire Division teamed up to explore:

  • Patient/Carer perspective - why we need early diagnosis of dementia?
  • Current data and how that can help drive change
  • Local initiatives
  • QI question: timely accurate diagnosis; access to neuroimaging and high-quality reports; and access to post diagnostic support

There was a Q&A session at the end.

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The first webinar in our series of free #DeansGrandRounds webinars was titled 'Improving the management of alcohol dependence for patients admitted to Mental Health Inpatient Units' and took place on Thursday 16 June 2022 from 4.00pm – 5.30pm.

The Faculty of Addictions Psychiatry and the West Midlands Division teamed up to examine the loss of addiction expertise in psychiatry. The issue is particularly timely as the requirement of the new GMC curriculum (starting August 2022) is for all CT1-3 trainees to demonstrate competence in the assessment and management of addiction.

The webinar explored the project in detail and included a presentation of PoMH data from 14 a,b,c) management of alcohol withdrawal in IP units and trends since 2014. An overview of local data sets was also presented.

Speakers and panellists included: Professor Subodh Dave, Professor Julia Sinclair, Dr Ed Day and Gemma, Dr Zafar Iqbal, Dr Renarta Rowe, Dr Rowena Jones and Kerry Webb, Dr Alina Braicu, Dr Deepa Bagepalli Krishnan, Dr Derrett Watts, Dr Muhammad Gul, and Dr Abdul Raoof.

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    Staff working in healthcare settings experience significant work-related mental health distress. An interplay of a number of personal, occupational and socio-environmental factors results in high rates of burnout and mental health problems amongst physicians.

    This session of Dean’s Grand Rounds focused on exploring and understanding this problem through physician experience, case studies and local data. The session also focused on some unique challenges in low and middle income countries and barriers to seeking mental health support amongst physicians.

    We heard about an innovative approach developed in the National Institute of Mental Health and Neuro Sciences (NIMHANS), India to enhance physician wellbeing.

     

    In South Africa, the prevalence of perinatal depression is as high as 32%, meaning that almost 1 in 3 pregnant women have some form of perinatal mental illness. Despite this alarming statistic, there are still limited perinatal mental health services available and there is poor screening during the antenatal period for common perinatal mental health problems.

    Pregnant women with mental illness go on to have poor maternal, obstetric, and neonatal outcomes; however, this experience is not unique to South Africa. Globally, racially and ethnically minoritized women disproportionately experience poor perinatal mental health care as a result of various factors, including stigma and psychosocial determinants of mental illness. Overall, this results in increased morbidity and mortality for the mother and baby, which is poorly documented and researched.

    Public health awareness, education, and screening is often skewed towards ensuring physical safety outcomes, without consideration of integrating mental health supports in perinatal services and well-baby spaces. This webinar focuses on how to address the challenges of providing integrated perinatal and infant mental health services in resource-constrained settings by highlighting clinical, educational, and research opportunities in South Africa.

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