Improving Cardiac Monitoring for Patients on Depot Antipsychotic Medication in a Mental Health Service for Homeless People

Aims Patients under the Joint Homelessness Team (JHT) in Westminster have poor health outcomes as they face double-hit of serious mental illness (SMI) and homelessness. Many patients are on depot antipsychotic medication to manage their SMI. Depot antipsychotics associated with increased risk arrythmias guidance advises annual electrocardiogram (ECG) monitoring for all (Maudsley: Prescribing Guidelines Psychiatry, Taylor). However, a proportion JHT not well engaged services do an ECG recorded SystmOne. In this QI study, we aimed improve percentage who within year SystmOne, from current level 80% over 4-month period. Methods 44 at were identified being (1 patient was later excluded due ongoing inpatient admission). PDSA cycles used period October 2022 January 2023. Intervention 1: Using available ECGs GP or secondary care records update SystmOne records. 2: Email requesting invite ECG. 3: inviting targeted ECGs. Results At baseline only 48.8% had last year. 1 our 72.1%. 2 completed 74%. Finally, intervention 3 83.7% by Mid-January Overall, results show improvement 34.9% relative increase 1.71 times amount 4 months. Conclusion As result incorporating dedicated liaison clinical time, improved uptake medication. We found there lot existing physical data that readily accessible JHT. future, development shared systems, both primary teams may be able save time resources avoiding duplication data. There remains room 16.3% still without This is accessibility engagement difficulties people SMI & history propose further portable machine these remaining patients. project business proposal secure funding device currently.