title: Service innovation: a comparison of two approaches for physical screening of psychiatric inpatients.
abstract: OBJECTIVE
  Psychiatric medications have clear links to obesity, diabetes, dyslipidaemia, hypertension, hyperprolactinaemia and movement disorders. These disorders are a common cause of morbidity and mortality in psychiatric patients but physical screening by health services is often haphazard.
  
  
  METHODS
  We report the findings of an audit of physical screening across two hospital wards. Each ward undertook a process of service improvement. One ward modified the admissions proforma and the other developed a discharge screening clinic. The effectiveness of each of these interventions was then compared through a reaudit of practice across both wards.
  
  
  RESULTS
  At baseline, screening was performed inconsistently and infrequently. On average, the modified admissions proforma increased screening rates by 4.7% compared to 30.7% for discharge screening clinics. The discharge screening clinic demonstrated statistically significant improvements in screening rates and effectively delivered health promotion advice.
  
  
  CONCLUSIONS
  Discharge screening clinics are significantly more likely than improved admissions procedures to detect clinically significant abnormalities. If these abnormalities are detected and treated then the long-term physical health of psychiatric patients may be improved.
authors: Department of Liaison Psychiatry, Wonford House Hospital, Exeter, UK. mark.harrison2@nhs.net
authors: Mark Richard
authors: MR
authors: Harrison
authors: Catherine Frances
authors: CF
authors: McMillan
authors: Timothy
authors: T
authors: Dickinson
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000517:prevention & control* / Q000523:psychology; D042241:Early Diagnosis; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008485:Medical Audit; D001523:Mental Disorders / Q000150:complications / Q000628:therapy*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010808:Physical Examination; D011567:Psychiatric Department, Hospital / Q000592:standards; D055815:Young Adult