Use of a quality improvement strategy to introduce co-design of the mental health discharge plan in rural and remote New South Wales.
Warren Kealy-Bateman, Calina Ouliaris, Luke Viglione and 2 others
PMID 34105212WHAT IT FOUND
In a rural mental health unit, all discharges in the audit month had completed summaries, and most plans were co-designed with patients and next of kin.
Nurses can use a simple checklist to include family, medications, follow-up and cultural needs.
Key findings
01In the May 2020 audit, 37 discharge summaries were completed and 32 were co-designed.
02Next of kin were contacted and engaged in care planning for 36 May 2020 discharges.
03Co-designing the discharge plan with the patient and next of kin became the standard.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
No data from consumers or their next of kin were obtained, so patient or family experience of co-design was not measured. The audit covered May 2020 in two units, so it may not apply to other months, units or patient groups. The project combined education, staff discussions, a memo and emails checking tasks, and an audit, so the contribution of any single element cannot be separated. Staff-reported improvements in summaries, engagement and cultural care were not compared with a control group or measured by patient outcomes. Junior medical staff turnover is identified as a challenge to maintaining the process.
Declared interests
No funding was received for this project.
The easy way to misread this
Do not read the high discharge summary completion rate as proof that co-design improved patient outcomes. The project did not collect patient or next of kin feedback, and education, memo checks and audit happened together, so the effect of any single part cannot be separated.