title: Does an admission booklet improve patient safety?
abstract: BACKGROUND
  The quality of admission clerking to psychiatry wards will influence initial management of patients suffering from mental illness. Incomplete clerking may put patient safety at risk.
  
  
  OBJECTIVE
  We sought to assess the completeness of clerking to general adult psychiatry wards and to evaluate whether the introduction of an admission booklet would improve clerking.
  
  
  METHODS
  We analysed the completeness of clerking to general adult psychiatric wards by trainee doctors. Using an audit approach, the first phase assessed completeness of clerking when trainee doctors used continuation sheets to document the clerking in a free-hand manner. Thereafter, we developed a standardised admission booklet to document the clerking and assessed completeness of clerking in the second phase.
  
  
  RESULTS
  The admission booklet significantly improved the completeness of clerking. Notable improvements were seen in multiple components of history taking and initial management, particularly in documenting risk to self and others.
  
  
  CONCLUSIONS
  Improving clerking by use of an admission booklet can lead to more informed management decisions particularly in regard to the patients' physical health and clinical risk management. This may consequently improve patient safety and help trainees communicate important aspects of the case to seniors and the wider multi-disciplinary team.
authors.affiliation: Academic Unit for Mental Health and Wellbeing, Centre for Population and Health Sciences College of Medical, Veterinary and Life Sciences University of Glasgow-Mental Health and Wellbeing, Glasgow, UK. Gavin.Wethers@glasgow.ac.uk
authors.forename: Gavin
authors.initials: G
authors.lastname: Wethers
authors.forename: Jennifer
authors.initials: J
authors.lastname: Brown
mesh_terms: D000328:Adult; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy; D008875:Middle Aged; D010343:Patient Admission / Q000592:standards*; D010353:Patient Education as Topic / Q000379:methods*; D061214:Patient Safety / Q000592:standards; D013664:Teaching Materials / Q000592:standards*