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Knowledge sharing tools for inpatient mental health settings

2 Aug

medical doctor with stethoscope. Over blue background

by Natasha Tyler, Research Associate in Safer Care Systems and Transitions theme

It is increasingly recognised that the coordination of care within and between care settings involves the sharing of information, knowledge and know-how between different professionals and service users. The extent of knowledge sharing, shared decision-making and care coordination is shown to influence the quality and safety of patient care. There is growing interest in promoting better knowledge sharing in mental health services, especially at the care transition points along the care pathway. Care transitions can refer to either those that take place within a hospital environment (i.e. handover from one shift to the next) or when moving from one environment to another (i.e. admission or discharge from/to hospital). However, there has been very little research looking at the effect of interventions that aim to improve knowledge sharing and patient safety at care transition points in mental health. The current study looks to explore the impact of implementing two co-designed knowledge sharing tools into mental health inpatient wards in one NHS Foundation Trust.  The first will seek to aid the admission process from the community to hospital and the second the nursing handover process from one shift to the next.

The catalysts for this work are numerous adverse safety incidents.  For example, a service user on the older adults mental health ward had a fall, but this information was not communicated to the staff on the next shift. The individual suffered adverse patient safety outcomes; which would not have occurred if his fall was communicated to the next shift. Researchers in the NIHR Greater Manchester PSTRC, based at the University of Nottingham, will work with staff on wards to co-produce a handover tool that ensures essential service user information is communicated effectively, and as a matter of course, between shifts.

The second admissions tool will be co-produced with staff in the same way; however this will look to capture important patient information from external organisations (such as primary care, the police, community teams) before the patient arrives on the ward. It is expected that this will reduce safety incidents, as important knowledge will be shared before the patient is admitted, allowing staff to better understand the patient’s history. It is expected that implementing the tool will have implications across the care pathway, as the tool will capture information about factors such as housing, past readmissions etc. which will also be necessary for reducing negative patient safety outcomes at discharge.

For more information on this project, you can contact Natasha Tyler via email at natasha.tyler@nottingham.ac.uk.

ReVerse: creative conversations between mental health service users and staff

6 Jun

Words_ReVerse illustration_cropped

by Bella Starling

Mental health service users, carers and staff have much in common these days coping with stress and distress, especially at a time of huge pressure on services.

ReVerse workshops aim to equalise the space between mental health service users and staff, to creatively nurture insight, dialogue and healing relationships about patient safety in mental health services and research.

We think a good way to do this is through poetry and spoken word. Creative formats can provide a different angle and unique insight into ourselves, others and our collective wellbeing, and provide those who often feel they are not heard with an opportunity to express their voices. Exploring metaphor and meaning can offer new dimensions to personal and professional health and research relationships.

The workshops are open to mental health service users, carers and staff (including clinical, research, managerial, administrative and support staff). We aim to have an equal mix of staff and service users. ReVerse workshops will include:

  • Examples and readings of poetry and/or spoken word, drawing from different experiences of mental health 
  • Discussions and reflections
  • Having a go: producing your own poetry or prose.

The ReVerse initiative is a collaboration between David Gilbert (poet, Patient Director and mental health service user) and Bella Starling (Wellcome Trust Engagement Fellow, Director of Public Programmes Team, Manchester University NHS Trust) and the NIHR Greater Manchester PSTRC.

For more information behind the workshops, see David’s recent blog post.

Our first workshop takes place in Ziferblat Media City on Tuesday 3 July, register your interest on our Eventbrite page. Registration is free, but requires a commitment to attend.

These workshops are pilots as part of an exciting new initiative. Those involved will help to shape the future development of this ReVerse Programme.

Improving patient safety: linking PSTRC research and expertise to policy and practice

14 Mar

Nav Kapur

Linking up with policy-makers and clinical services is an important part of the work of the NIHR Greater Manchester PSTRC.  Nav Kapur, who is a Professor at the University of Manchester and one of the Research Leads for the Centre, really values the wider engagement he has had with NICE (he chaired the NICE self-harm and depression guidelines), the Department of Health and Social Care,  and Health Education England amongst others.  

Nav says: “We are proud to be a leading centre for research into self-harm and suicide and it’s been a privilege to inform policy and practice.  As an academic, being involved in guideline development allows you to get a wider view of the worldwide literature and its impact on patients.  As a clinician, I like the fact that being involved in guidelines and policies allows you to improve the care of all patients, not just the patient in front of you.”

He continues: “As part of my role as a member of the National Suicide Prevention Strategy Advisory Group for England I contributed to the new suicide prevention strategy, particularly its emphasis on self-harm, as well as contributing to initiatives on confidentiality and responding to new methods of suicide.  My work with Health Education England aims to develop competencies for all NHS staff in the assessment of patients who present with suicidal thoughts or self-harm.” 

Nav also values his role contributing to the induction of new chairs for NICE Guidelines. He explains: “In some ways I find it quite strange that I am now one of the most experienced guideline chairs!  But I really enjoy sharing my experiences of chairing groups and guideline development with people just embarking on the process and I hope they find it helpful too.” 

Nav and colleagues including Roger Webb and Caroline Sanders who lead the Safety in Marginalised Groups theme are looking forward to contributing further to guidelines and policy and practice.  In particular the planned work on the management of self-harm, the safety of mental health services, and improving care for marginalised groups could have a major impact on patient safety and patient care.        

PhD fellow focus: Lukasz Cybulski

2 Feb

In this series, we meet our new PhD fellows to find out what they will be researching and what they hope to achieve.

Lukasz Cybulski started his PhD in September 2017. He has a background in research and mental health work with an interest in the synthesis of public health policy, the use of research findings in the ‘real-world’ and ways of increasing research transparency and reproducibility. The opportunity to combine these interests is what drew him to the projects at the Greater Manchester Patient Safety Translational Research Centre.

His PhD will focus on self-harm and suicide in children, adolescents and young adults. The epidemiology (the study of how diseases affect the health and illness of populations) of self-harm and suicide has not been extensively studied among registered primary care patients. The majority of people diagnosed with a mental health disorder, including conditions such as depression, anxiety disorders and eating disorders, are rarely referred to, or treated by, specialist mental health services.

Lukasz will investigate this topic using a nationally representative group of primary care patients,  linking with routinely collected clinical datasets and national mortality records. This will provide a unique platform for investigating people diagnosed with ‘mild to moderate’ mental health problems, their clinical management across healthcare sectors, and their subsequent risks of nonfatal and fatal suicidality and other causes of premature death. Epidemiological studies of this nature allow for the identification of populations at particular risk, and aid the development of clinical guidelines that maximise patient safety.

New research themes in the PSTRC

1 Feb

All-theme banner

The PSTRC will build on its existing themes of Safety Informatics and Medication Safety, and their specific focus on digital and diagnostic interventions and polypharmacy. However, the 2017-2022 PSTRC differs from its predecessor in having two new themes:

  • Safer Care Systems and Transitions
  • Safety in Marginalised Groups.

Safer Care Systems and Transitions will build on the centre’s previous work on multimorbidity to look at transitions and pathways of care. Transitions can be from one part of the NHS to another (e.g. hospital to primary care), between NHS and private care providers, between the health and social care sectors, or between other sectors and sites including the voluntary sector, self-help groups or “home.”  Most research and advances in patient safety are typically found within single discrete care settings, such as the emergency department. Less attention has been paid to safety between (transitional) primary, social and community providers and hospital care settings.

The second new theme is Safety in Marginalised Groups. Marginalised Groups include people that are excluded from mainstream social, economic and cultural life. This includes those with mental illness or at risk of suicide or self-harm, people living in nursing homes, the homeless, people with sensory impairment or who speak English as a second language. Such groups are at greater risk of experiencing adverse patient safety outcomes.

In all research themes, service responsibility and patient responsibility for patient safety go hand-in-hand. They are equal – it is a shared responsibility that requires co-design and partnership working, which is why the PSTRC has an involvement and engagement approach supporting all its research.