Improving Communication With Relatives on an Older Adult Mental Health Inpatient Ward: A Quality Improvement Project

Introduction Communication with relatives is a vital part of delivering high-quality healthcare, particularly within older adult mental health inpatient services where many patients have cognitive impairment or severe mental illness. The involvement of family members is especially crucial given that patients often rely upon family members to support decision-making and discharge planning. During the COVID-19 pandemic, visiting restrictions drastically reduced opportunities for face-to-face communication, resulting in increased anxiety amongst relatives and increased telephone enquiries to ward staff. This quality improvement project (QIP) aimed to improve the quality, consistency and frequency of communication with relatives of patients admitted to an older adult psychiatric inpatient ward by introducing a structured written communication process, with the goal of increasing relatives' involvement in care and reducing telephone requests for clinical updates. Methods A QIP was undertaken on a 20-bed older adult psychiatric assessment ward within North London NHS Foundation Trust to improve the quality, consistency and frequency of communication with relatives. Baseline feedback from relatives identified a wish for more regular, structured updates, with a majority expressing a preference for written communication via email. Four iterative Plan-Do-Study-Act (PDSA) cycles were undertaken to develop and refine a standardised written feedback template that was emailed to relatives following multidisciplinary ward reviews. Results Satisfaction amongst relatives improved throughout the project, with mean feedback scores increasing from 4.25/5 during the first cycle to 4.94/5 by the fourth and final cycle. Relatives consistently reported feeling better informed and more involved in their family member's care. Nursing and administrative staff also reported fewer telephone enquiries requesting clinical updates, suggesting reduced administrative burden and improved efficiency. Conclusions The intervention proved acceptable to relatives and staff, required minimal financial investment, and became embedded into routine clinical practice. Standardised written communication represents a simple, sustainable intervention that may improve family experience and reduce staff workload within older adult mental health inpatient services.