Essence of Care

“Safety of patients with mental health needs in acute mental health and general hospital settings.”

Improving Patient Experience and Care through Practice and Quality ImprovementNIPEC Conference, 27th March 2007Hilton Templepatrick Hotel

Essence of Care

Essence of Care arose from :

Making a Difference (1999)

The NHS Plan (2000)

A first Class Service (1998)

“Safety of patients with mental health needs in acute mental health and general hospital settings.”

Improving Patient Experience and Care through Practice and Quality ImprovementNIPEC Conference, 27th March 2007Hilton Templepatrick Hotel

Essence of Care

Representation from :

Nursing, (ward based and community) Psychology Occupational Therapy SecretariesDomestic ServicesMedicalPatient representative and a carer.

“Safety of patients with mental health needs in acute mental health and general hospital settings.”

Improving Patient Experience and Care through Practice and Quality ImprovementNIPEC Conference, 27th March 2007Hilton Templepatrick Hotel

Essence of Care

Factor 1. Orientation to the Health Environment Factor 2. Assessment of Risk of patients/clients

with mental health needs harming self.Factor 3. Assessment of Risk of patient/client

with mental health needs harming others.

Factor 4. Balancing Observation and Privacy in a Safe Environment.

Factor 5. Meeting patients / clients safety needs. Factor 6. A Positive Culture to Learn from

Complaints and Adverse Incidents related to harm and abuse.

“Safety of patients with mental health needs in acute mental health and general hospital settings.”

Improving Patient Experience and Care through Practice and Quality ImprovementNIPEC Conference, 27th March 2007Hilton Templepatrick Hotel

Essence of Care

Method: PRESENTING THE EVIDENCE OF CURRENT PRACTICE

Factor 1: Orientation to the Health Environment Examples best practiceBarriers that prevent achievement of best practice:

Welcome patients to environment Induction to ward Orientation to ward should be ongoing process when

necessary. Restricted areas for both male and female patients Vulnerable patients given a single room Key Nurse allocated Information leaflets informing patients appointments etc

what to expect 

“Safety of patients with mental health needs in acute mental health and general hospital settings.”

Improving Patient Experience and Care through Practice and Quality ImprovementNIPEC Conference, 27th March 2007Hilton Templepatrick Hotel

Essence of Care

From our discussions a number of recurrent themes were identified across all six factors.

These were:1. Orientation to the health environment2. Safety and risk3. Resources4. Complaints

“Safety of patients with mental health needs in acute mental health and general hospital settings.”

Improving Patient Experience and Care through Practice and Quality ImprovementNIPEC Conference, 27th March 2007Hilton Templepatrick Hotel

Essence of Care

Orientation to the health environment:

A number of recommendations were made:An information / communications group should

be established to ensure adequate and appropriate information is available to staff, patient / clients and carers.

The core of this will be a resource room with internet access, books, journals, information leaflets and audio visual material.

“Safety of patients with mental health needs in acute mental health and general hospital settings.”

Improving Patient Experience and Care through Practice and Quality ImprovementNIPEC Conference, 27th March 2007Hilton Templepatrick Hotel

Essence of Care

Safety and risk:

The risk assessment tool has been reviewed and amended.

 The serious risk indicator tool has been audited.Observation policies have been reviewed.Review of discharge procedures leading to a pilot study

and the creation of a post for a discharge expeditor.McCleery report, risk assessment, and discharge

planning is now a priority.

“Safety of patients with mental health needs in acute mental health and general hospital settings.”

Improving Patient Experience and Care through Practice and Quality ImprovementNIPEC Conference, 27th March 2007Hilton Templepatrick Hotel

Essence of Care

Resources:

Financial restraints Value the resources we have:

Families and carers Staff (Recruitment and retention)

Improvements to the physical environment: Windsor House is not accepted as adequate to meet the needs of a modern comprehensive mental health service.

“Safety of patients with mental health needs in acute mental health and general hospital settings.”

Improving Patient Experience and Care through Practice and Quality ImprovementNIPEC Conference, 27th March 2007Hilton Templepatrick Hotel

Essence of Care

Complaints

Essence of Care Group mostly satisfied with the operation of the Belfast City Hospital Trusts’ complaints policy.

 However, more could be done to make make it easier for patients / clients and carers to make a complaint.

It was recognised that community patients would have greater difficulty in accessing the complaints procedure than inpatients.

“Safety of patients with mental health needs in acute mental health and general hospital settings.”

Improving Patient Experience and Care through Practice and Quality ImprovementNIPEC Conference, 27th March 2007Hilton Templepatrick Hotel

Essence of Care

Complaints:

Staff should have feedback on outcomes of complaints.

“Safety of patients with mental health needs in acute mental health and general hospital settings.”

Improving Patient Experience and Care through Practice and Quality ImprovementNIPEC Conference, 27th March 2007Hilton Templepatrick Hotel

Essence of CareProcess:

“Safety of patients with mental health needs in acute mental health and general hospital settings.”

Phase 1 Agree area of practice

Phase 2 Establish a Comparison Group

Phase 3Agree best practice

Phase 6 Phase 4Action Scoring

Phase 5Comparing / Sharing

Phase 7Dissemination