Oxford Healthcare Improvement (OHI)https://oxfordhealth-nhs.archive.knowledgearc.net/handle/123456789/8342023-07-27T23:25:20Z2023-07-27T23:25:20ZImproving mealtimes for patients and staff within an eating disorder unit: understanding of the problem and first intervention during the pandemic—an initial reportGardner, LucyTrueman, Hayleyhttps://oxfordhealth-nhs.archive.knowledgearc.net/handle/123456789/8162021-05-24T18:50:27Z2021-04-01T00:00:00ZImproving mealtimes for patients and staff within an eating disorder unit: understanding of the problem and first intervention during the pandemic—an initial report
Gardner, Lucy; Trueman, Hayley
Background Mealtimes occur six times a day on eating disorder (ED) inpatient units and are a mainstay of treatment for EDs. However, these are often distressing and anxiety provoking times for patients and staff. A product of patients’ distress is an increase in ED behaviours specific to mealtimes. The aim of this quality improvement project was to decrease the number of ED behaviours at mealtimes in the dining room through the implementation of initiatives identified through diagnostic work.
Methods The Model for Improvement was used as the systematic approach for this project. Baseline assessment included observations in the dining room, gathering of qualitative feedback from staff and patients and the development of an ED behaviours form used by patients and staff. The first change idea of a host role in the dining room was introduced, and the impact was assessed.
Results The introduction of the host role has reduced the average number of ED behaviours per patient in the dining room by 35%. Postintervention feedback demonstrated that the introduction of the host role tackled the disorganisation and chaotic feeling in the dining room which in turn has reduced distress and anxiety for patients and staff.
Conclusions This paper shows the realities of a quality improvement (QI) project on an ED inpatient unit during the COVID-19 pandemic. The results are positive for changes made; however, a large challenge, as described has been staff engagement.
Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
2021-04-01T00:00:00ZBuilding improvement capacity in mental health servicesVincent, Charleshttps://oxfordhealth-nhs.archive.knowledgearc.net/handle/123456789/6572020-12-09T16:38:39Z2020-10-01T00:00:00ZBuilding improvement capacity in mental health services
Vincent, Charles
Improving the delivery of existing treatment may often bring much greater benefits than developing new treatments and technologies. To achieve this, clinical teams and organisations need to build capacity for sustained and systematic improvement. Organisations can build improvement capacity and skills by developing permanent multidisciplinary centres to provide sustained inspiration, research, training and practical support for implementation and innovation. In the longer term, organisations need to build an infrastructure for quality improvement that includes an information system to track change and dedicated improvement leads across the organisation.
Open Access
2020-10-01T00:00:00ZEnvironmental changes to reduce self-harm on an adolescent inpatient psychiatric ward: an interrupted time series analysisReen, GurpreetBailey, JillMcGuigan, LornaBloodworth, NatashaVincent, Charleshttps://oxfordhealth-nhs.archive.knowledgearc.net/handle/123456789/5952021-08-13T15:34:19Z2020-07-01T00:00:00ZEnvironmental changes to reduce self-harm on an adolescent inpatient psychiatric ward: an interrupted time series analysis
Reen, Gurpreet; Bailey, Jill; McGuigan, Lorna; Bloodworth, Natasha; Vincent, Charles
Existing interventions to reduce self-harm in adolescents admitted to psychiatric wards are usually focused on individual psychological treatments. However, the immediate ward environment in which treatment takes place is an important factor in the success of the treatment and can also influence the likelihood of self-harming behaviours. The aim of the current study was to evaluate changes made to a psychiatric ward environment on incidence of self-harm in adolescents. A quasi-experimental interrupted time series study was conducted on one child and adolescent psychiatric ward. An intervention was developed alongside staff and patients to address the high incidence of self-harm on weekday evenings on the ward. The intervention components involved adding a regular twilight shift (3–11 pm) for nursing staff and introducing a structured evening activity programme on the ward. A segmented regression analysis of an interrupted time series found that the rate of self-harm per 100 bed days was already declining at baseline and continued to decline post-intervention, but the rate of decline was not significant (p = 0.415). However, the proportion of patients self-harming was increasing at baseline and significantly reduced post-intervention (p = 0.001), and this reduction was significantly larger in the evenings (p = 0.004) compared to other times of day (p = 0.09). A tailored intervention targeting the psychiatric ward environment helped to reduce the proportion of adolescents self-harming on the ward. An interrupted time series analysis should be considered for future interventions making changes to health systems over time.
Open access
2020-07-01T00:00:00ZBuilding improvement capability in frontline staff: a UK perspectiveMaughan, Daniel LReen, GurpreetBailey, Jillhttps://oxfordhealth-nhs.archive.knowledgearc.net/handle/123456789/5682021-08-13T15:33:10Z2020-06-01T00:00:00ZBuilding improvement capability in frontline staff: a UK perspective
Maughan, Daniel L; Reen, Gurpreet; Bailey, Jill
This paper gives a narrative account of how the Oxford Healthcare Improvement Centre has embedded continuous quality improvement (CQI) across both mental health and community services in Oxford, UK. The aim of the centre is to develop capability across healthcare services, with frontline staff leading CQI independently. The paper discusses the various methods employed to achieve this aim, including the provision of training, mentoring and support to those undertaking improvement work, alongside developing the required governance for CQI.
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
2020-06-01T00:00:00Z