Ensuring quality immediate discharge letters from mental health

Development and testing of the QDis-MH checklist for discharge letters from specialised mental healthcare: a stakeholder-centred study

BACKGROUND

The 'discharge letter' is the mandatory written report sent from specialists in the specialist services to general practitioners (GPs) on patient discharge. Clear recommendations from relevant stakeholders for contents of discharge letters and instruments to measure the quality of discharge letters in mental healthcare are needed. The objectives were to (1) detect which information relevant stakeholders defined as important to include in discharge letters from mental health specialist services, (2) develop a checklist to measure the quality of discharge letters and (3) test the psychometric properties of the checklist.

METHODS

We used a stepwise multimethod stakeholder-centred approach. Group interviews with GPs, mental health specialists and patient representatives defined 68 information items with 10 consensus-based thematic headings relevant to include in high-quality discharge letters. Information items rated as highly important by GPs (n=50) were included in the Quality of Discharge information-Mental Health (QDis-MH) checklist. The 26-item checklist was tested by GPs (n=18) and experts in healthcare improvement or health services research (n=15). Psychometric properties were assessed using estimates of intrascale consistency and linear mixed effects models. Inter-rater and test-retest reliability were assessed using Gwet's agreement coefficient (Gwet's AC1) and intraclass correlation coefficients.

RESULTS

The QDis-MH checklist had satisfactory intrascale consistency. Inter-rater reliability was poor to moderate, and test-retest reliability was moderate. In descriptive analyses, mean checklist scores were higher in the category of discharge letters defined as 'good' than in 'medium' or 'poor' letters, but differences did not reach statistical significance.

CONCLUSIONS

GPs, mental health specialists and patient representatives defined 26 information items relevant to include in discharge letters in mental healthcare. The QDis-MH checklist is valid and feasible. However, when using the checklist, raters should be trained and the number of raters kept to a minimum due to questionable inter-rater reliability.

The Network Structures and Characteristics of Global Hubs of STI in Big Data Analysis and Mining Technology

Global hubs of STI are strategic nodes in the global science network and will lead the future of global scientific progress. This paper takes big data analysis and mining technology as an example, exploring the structures and characteristics of global science network of 15 representative global hubs of STI from 2000 to 2019. Based on the data of highly cited papers and methods of social network analysis, we find that the global science network has the structure of hierarchy, with an obvious characteristic of regionality. Based on the structures and characteristics of global science network, the knowledge flow and management model of global hubs has been proposed, which may be conducive to strengthening the knowledge management and network collaboration among global hubs of STI in other frontier technologies.

Requirements for an electronic handover system for interprofessional collaboration between psychotherapists and occupational health professionals - a qualitative study

BACKGROUND

An electronic handover system provides a potential way to bridge the interface between psychotherapy and occupational health. This qualitative study therefore aimed assessing (1) content-related and (2) functional requirements that psychotherapists and occupational health professionals expect from an electronic handover system to exchange relevant information about their patients with common mental disorders.

METHODS

Five focus groups with psychotherapists and occupational health professionals (occupational physicians and members of company integration management) were conducted via video conference using an interview guide. The focus groups were transcribed and content-analysed using MAXQDA.

RESULTS

With regard to content-related requirements, information that serve to assess employee's ability to work was described as particularly relevant by occupational physicians and members of company integration management (e.g. restrictions in certain work areas or ability to work under time pressure). Psychotherapists indicated that information about the employee's working conditions is particularly relevant. This includes description of work tasks or conflicts at the workplace. Concerning functional requirements, all professional groups attached importance to data security and functions to improve communication and collaboration (e.g. the use of standardised handover forms).

CONCLUSION

This study provides insight into the desired content-related and functional requirements by psychotherapists, occupational physicians and members of company integration management for an electronic handover system. However, the theoretical and practical development of such a system requires several additional steps, such as the involvement of further relevant stakeholders (e.g. patients, software developers).