Developing and Implementing a Quality Assurance Strategy for Electroconvulsive Therapy

Abstract Objectives The objectives of this quality assurance project was to assess the practice of electroconvulsive therapy (ECT) in a psychiatric hospital by measuring the degree of compliance with Electroconvulsive Therapy Accreditation Service (ECTAS) standards. Method An audit tool was developed utilizing a quality criteria checklist by examining the ECTAS standards in relation to the requirements for ECT suites and reviewing the case notes of all patients who had ECT during the period between January 2017 and October 2017 (first audit) and January 2018 and October 2018 (re-audit). Data were quantitatively analysed and described. Results The psychiatric unit ECT practice generally was found to adhere to the ECTAS Standards. During the audit period, 29 patients received an ECT course. The mean age was 56 years with equal gender distribution. Bilateral ECT was used in all cases. Severe depressive illness was the most common indication for ECT treatment, followed by catatonia and severe suicidality. The ECT prescription was completed by the treating consultant psychiatrist in all patients’ records (100%) in both audits. However, the signature of the doctor administering ECT was not present in 40% in the first audit and 21% in the second audit. Conclusion High quality ECT is important not only for safe ECT, but is also an important step in removing the stigma that exists around this effective and occasionally lifesaving procedure. This complete audit cycle demonstrates the value of examining ECT care by highlighting areas of accomplishment as well as areas that require further development.