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An audit of risk assessment in an emergency setting

  • James Stone (a1) and George Szmukler (a2)
Abstract
Aims and Method

Patient records from the emergency clinic at the Maudsley Hospital were analysed from July 1999 to assess the standard of risk assessment for self-harm and for harm to others routinely recorded by junior doctors. The recorded risk factors for the consultation and the evidence that risk had been considered were noted. An intervention that comprised two seminars and two written reminders about the importance of risk assessment was made and the analysis of records in the emergency clinic repeated for July 2000.

Results

Risk factors were recorded more frequently for harm to self than for harm to others. There was little recorded evidence that consideration had been given to the overall risk of harm to self, and there was no evidence of this for harm to others. Recording of risk did not change significantly between 1999 and 2000.

Clinical Implications

Assessment for risk of harm to others is not a part of the emergency consultation that is emphasised by the majority of junior psychiatrists. Changing practice will require a shift in the way that risk to others is presented in psychiatric teaching.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Department of Health (1999a) Modernising the Care Programme Approach: A Policy Booklet. London: Department of Health.
Department of Health (1999b) National Service Framework for Mental Health. London: HMSO.
NHS Centre for Reviews and Dissemination (1999) Getting evidence into practice. Effective Health Care Bulletin, 5(1)116.
Szmukler, G. (2001) Violence risk prediction in practice. British Journal of Psychiatry, 178, 8485.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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An audit of risk assessment in an emergency setting

  • James Stone (a1) and George Szmukler (a2)
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