1 November 2023

The Joint Homelessness Team (JHT) in Westminster have run a series of Quality Improvement projects to improve physical health monitoring for their patients.

This work forms part of a series of improvement projects on physical health that the team have planned and follows on from a successful project poster presented at the Royal College of Psychiatrists International Congress 2022.

The team shared their work to improve recorded annual physical health checks according to Trust Key Performance Indicators (KPI) for weight; hypertension; diabetes; cholesterol; and screening for smoking, drugs and alcohol. Their initial target was to screen 90% of patients by December 2021.

Using monthly physical health reports to target uncompleted annual health checks for their 135 patients, the team tested three interventions using Plan, Do, Study, Act (PDSA) cycles:

    • Intervention 1: Using available electrocardiograms (ECGs) from GP or secondary care records to update staffing records.
    • Intervention 2: Emailing GPs requesting that they invite patients for annual ECGs.
    • Intervention 3: Inviting patients for targeted ECGs.

Working from a place where only 48.8% of patients had an ECG recorded on SystmOne (a clinical record system which stores patient health records electronically and securely) within the last year, the project increased this figure to 83.7% in four months.

Building from previous successful projects the team are moving to sustain a third project run this year aiming to improve the percentage of JHT patients on oral antipsychotic medication who have a recorded ECG on Systm1 in the last year which has seen a 22% improvement.

In July 2023, they presented a poster (2023 poster attached) on their work at Royal College of Psychiatrists International Congress 2023 in Liverpool to improve the percentage of JHT patients on depot antipsychotic medication who have a recorded ECG within the year on SystmOne, from current level to 80% over four months.