Right, first session of today at #quality2021: Quality Improvement at National Scale: The theory and results of two national collaboratives using QI to address human rights issues and safety in mental health. Amar Shah is welcoming us to the session.
We're being joined for this session at #quality2021 by Ajibola (Aji) Lewis, Sal Smith and Kate Lorrimer. Shah says patients in hospital for mental health reasons experience same risks as other hospital patients, but with other risks to their safety related to their mental health
Shah says that there is relatively little work that's been done about patient safety in mental health settings. Says there is a tension between autonomy and reducing risk which is often present in mental health situations #quality2021
Aji Lewis is now now talking about her son, Seni, who died while being restrained face down. Lewis telling us about her son and who he was. For more of Seni's life and Aji's loss see here restraintreductionnetwork.org/uncategorized/… #quality2021
Aji Lewis is telling story of Seni's life. in 2010 he experienced a psychotic episode, was admitted as a voluntary patient , ended up in A+E. tried to leave, was restrained in a prone position by police. Seni died. Lewis learned of these details from a whistleblower #quality2021
Aji Lewis says she speaksso people will stop and think. Asks anyone restaining people to think 'why am I not respecting these people? Why am I pumped up? Why aren't I deescalating the situation?These are people, not numbers. Line between life and death is so thin." #quality2021
Aji Lewis says 'your conscience will not let you get away with it. Do. Not. Do. It; I beg you, think before you restrain anyone. You can never go back and make it right' Says check out Seni's Law mind.org.uk/news-campaigns… #Quality2021
Now Saiqa Akhtar of National Collaborating Centre for Mental Health telling us about the Reducing Restrictive Practice Collaborative rcpsych.ac.uk/improving-care… #quality2021
As Saiqa Akhtar says, it's hard to follow Aji Lewis and her loss and work. I agree, so I apologise if my tweeting is a little slow for a moment #quality2021
Akhtar says that they were concerned with restraint, seclusion and rapid tranquilisation. They used a PDSA approach (Plan, Do, Study, Act). Worked to develop a theory of change, standardise language and description, brought teams together across sites, coached #Quality2021
(Here's a guide to PDSA cycles for quality improvement england.nhs.uk/wp-content/upl…) #quality2021
Ahktar: 570 ideas were generated, 15 were tested. 100% of wards collaborated with service users. 66% saw reduction in restraint, 61% saw reduction in seclusion. Changes that saw the biggest impact was changing relationship between patients and ward staff #quality2021
Akhtar: says that coproduction was important, as was the license to make change. As was shared learning #quality2021
Now up Sal Smith, speaking about trauma informed care/ She's a trauma informed care lead in an NHS trust, using her own experience. She's talking about the importance of the Sexual Safety Collaborative rcpsych.ac.uk/improving-care… #quality2021
Sharing her own experiences, Smith is talking about her first contact with mental health inpatient services. She says she was relieved when she was told she'd be admitted to hospital at 19. She says she was naive, would tell her 19 year old self to run the fuck away #quality2021
Smith says that she lost more and more of herself during mental health care, despite the efforts of some good staff. She says she was not safe in her body or mind. She's talking about her traumatic experiences while an inpatient. She says this was routine #quality2021
Smith says hospital did not keep her safe. It put her in danger. Says she has found far more peope with similar experiences. Says we must pay attention to the power of poor inpatient care to trigger those with experience of sexual assault. Places aren't safe #quality2021
Smith says real kindness comes from not turning away from the horrors in people's lives. Sexual assault happens in mental health hospital and it should not. Smith: being witnessed, believed, heard is important. Says it's relationships that change things #quality2021
Kate Lorrimer is up now, speaking more about the Sexual Safety Collaborative. NHS England commissioned national sexual safety standards, did 18 month collaborative. Aim was to increase % of patients and staff who felt safe from sexual violence on mental health wards #quality2021
Lorrimer: we measured sexual safety via a twice monthly two question postcard. They launched in 2019, addressing an area that professions had not addressed before. Worked with teams to understand what sexual safety meant and what it meant for different people #quality2021
Lorrimer: the collaborative paused during the pandemic. Restarted in September 2020. Says they don't have quantitative data yet, but says they are seeing that it's culture shift that's the important thing. Says they'd also measure staff confidence if starting again #quality2021
Lorrimer says we need to shift to treating people as whole people. Says that QI approach has been vital in acting upon culture and practice and forms a way for patients/users staff and other to come together within making stuff happen that makes a difference #quality2021
Shah is now sharing a question from audience about exactly how service users were involved in generating ideas. Ahktar says there were a number of ways, meetings, group ideas meetings, noticeboards on wards for ideas sharing, staff on teams #quality2021
Shah is now asking a question from the audience about resistance from staff to change. Lorrimer says that the biggest resistance was around restrictive practice as some staff felt it kept them and others 'safe'. Says that seeing change in action changed minds #quality2021
Shah is now thanking our presenters and acknowledges the power of Aji and Sal's experiences to make change and the importance of the Collaborative in making safety happen within the framework of quality improvement. #quality2021
That's it for this session at #quality2021. I didn't turn away, and wanted to share solidarity with all who have been made unsafe in mental health care. Join me at 12.15GMT for "Creativity as core in QI - using the Arts to empower and build co-production" See you in a bit!
More resources and learning from the session
https://twitter.com/DrAmarShah/status/1402582579447054340?s=20
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