Clinically useful scales must be reliable. High inter‐rater reliability reduces errors of measurement. The purpose of this study was to assess the agreement between raters in scoring items of the Westmead post‐traumatic amnesia (PTA) scale. Two raters viewed 20 episodes of the Westmead PTA scale in clinical use. The inter‐rater reliability coefficients for the instrument overall and for a majority of the individual items were statistically convincing (r ≥ 0.72) and well within clinically acceptable ranges. The lowest correlation was for the item pertaining to recognition of the examiner's face. A procedure for improving the reliability of scoring this item is recommended.
Failing to return from leave from acute psychiatric wards can have a range of negative consequences for patients, relatives and staff. This study used quality improvement methodology to improve the processes around patient leave and time away from the ward. The aim of this study was to improve rates of on-time return from leave by detained and informal patients by 50%.Following a baseline period, four interventions were implemented and refined using PDSA cycles. The main outcome measure was the proportion of periods of leave where the patient returned on time. Late return was defined as failure to return to the ward within 10 minutes of the agreed time.At baseline, the rate for on-time return was 56.0%; this increased to 87.1% post-intervention, a statistically significant increase of 55.5%. SPC charts show that the interventions were associated with improvements. The improvements have been sustained and the interventions are fully embedded into daily practice. The project was refined to local context and trialled on six additional wards: four of the six wards have successfully implemented the interventions and have on-time return rates of over 90%.This project produced a marked and sustained improvement in patients returning on-time from leave, facilitating a more open discussion between staff and patients about the purpose and value of periods away from the ward. Quality improvement approaches can be effectively applied in mental health settings.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.