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The Royal College of Psychiatrists Improving the lives of people with mental illness

Spotlight on quality - case study 3

Spotlight on quality

Quality Improvement: a case study

Last month the college’s Quality Improvement lead Amar Shah brought you the second of a series of QI case studies, which we hope will inspire ideas for quality improvement in your areas of work.

It focused on work done by the East London Memory Clinics, part of East London NHS Foundation Trust.

This month we’re looking at a project which took place at the Adult Learning Disability Unit in Durham.


The project in brief

Using Quality Improvement Methodology (QIS) methodology (the RPIW improvement process, to be specific) the unit

  • improved patient flow

  • continued to offer an excellent quality patient care

  • reduced bed numbers

  • changed staff numbers to support more community based activity so patients could stay in their own home.


Impact & results


The impact of the RPIW is being felt across LD inpatient services and in addition to the results above the RPIW has delivered:

  • Visual control boards reduced from 3 boards down to one making things more action focused

  • 12 consultant ward rounds across 3 units reduced down to  a daily huddle in the remaining 2 units

  • 31.25% reduction in bed numbers

  • 60% reduction in consultant time required in unit

  • 100% reduction in non-productive meetings

  • 100% of patients now get a formal formulation (76% previously)

  • Saving of 592 miles per week of community staff travelling to ward rounds

  • 68% reduction in staff time spent prepping for and attending meetings (was previously 126 hrs per week)


Qualitative Results and feedback

  • Timely care

  • Governance compliance

  • Patient turnover –average bed occupancy is 21 days

  • In line with transforming  care-care is delivered in the community

  • Generates Business for the trust

  • Improved Inter-agency working and partnership working

The Inpatient Review RPIW has been a resounding success and illustrates the efficacy of the trust’s Quality Improvement System.  It also demonstrates the continued commitment of the Learning Disability division to develop innovative treatments that avoid restrictive practices wherever possible and minimize them where absolutely necessary.



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