Standardising electroconvulsive therapy for better patient outcomes
Director of ECT for Redcliffe-Caboolture Mental Health Services Dr Simone Garrett-Walcott
Metro North Mental Health clinicians have piloted a standardised protocol for patients receiving Electroconvulsive Therapy (ECT), to ensure all patients receive the same high standard of care.
ECT is a highly effective treatment with a strong evidence base for patients with severe mental health conditions, offering hope and relief when other interventions have been ineffective. However, ensuring consistent and effective care for patients undergoing ECT has long been a challenge, with variations in clinical practice.
Director of ECT for Redcliffe-Caboolture Mental Health Services Dr Simone Garrett-Walcott and her team have piloted the implementation of a standardised protocol for monitoring the cognition and treatment response in ECT patients.
“While we monitor cognition and treatment response for every patient, every consultant has been doing this differently, so this protocol allows a standardised approach that is used for every patient across our service,” Dr Garrett-Walcott said.
To address this, Dr Garrett-Walcott used a multi-theory implementation science approach to the design, implementation and embedding of a protocol to inform the process. This was to increase the likelihood of uptake and effectiveness, and to ensure all patients receive the same monitoring during ECT.
The protocol, which followed extensive consultation with clinical teams across Metro North Mental Health services, outlines the clinical instruments that should be conducted before and during treatment, as well as the specific time points for assessment. This ensures that any potential cognitive side effects, such as memory loss, are identified and managed promptly, while also evaluating the efficacy of the treatment.
The protocol was piloted over a three-month period at Redcliffe-Caboolture Mental Health service, where it was met with positive feedback from staff.
“We conducted a survey at the end of the pilot to understand the staff’s comfort level with the protocol and how well it had been embedded into their clinical practice,” Dr Garrett-Walcott said.
The results were encouraging, demonstrating that the protocol was both practical and effective in standardising care.
Dr Garrett-Walcott’s work underscores the importance of standardisation in healthcare.
“ECT is the most invasive treatment in psychiatry and is not without risks,” she said.
“It’s crucial that all patients receive the same level of care, regardless of which facility they’re being treated in, or which doctor is providing the treatment.
“By standardising ECT care, we are helping ensure that patients across Metro North receive the highest standard of treatment, ultimately leading to better outcomes and greater equity in mental health care.
“Standardised protocol also enables clinicians to work more effectively and confidently when treating patients.”
Future research involves further embedding the protocol across all Metro North facilities and investigating opportunities to align it with similar initiatives in other states.