Audit of an electroconvulsive therapy clinic's missed-fit rate

Aims and Method To audit the missed-fit rate of a consultant-led electroconvulsive therapy (ECT) clinic adhering to a stimulus dosing policy. After an initial first audit a standard for the missed-fit rate was set at ≤ 5%. A second and third audit examined whether the standard was met and then maintained over time. Results The audit standard of maintaining a missed-fit rate ≤;5% was achieved in the second audit and maintained in the third audit. The missed-fit rate dropped from 5% in the first audit, to 2% in the second audit and to 1.8% in the third audit. Clinical Implications A missed-fit rate of ≤ 5% was achieved and maintained over a 6-year period with rigorous adherence to a stimulus dosing policy in a consultant-led ECT clinic. This compares favourably with missed-fit rates of 25% found in national audits of ECT. A missed-fit rate of ≤ 5% might provide one possible standard for the efficiency of ECT clinics nationally.