Inpatient Quality and Safety work at ELFT
Teams from all inpatient sites across the trust are working to improve Inpatient Quality and Safety on the wards. This is an important area to tackle and forms part of the trust’s commitment to improving experience for those we serve.
Teams will be using Quality Improvement (QI) to tackle two main areas as part of the work: therapeutic engagement and observations, and the ELFT safety culture bundle.
The work is represented below as a driver diagram which displays the current theory of change around this work
As part of the work, teams will have access to a range of support from across the trust including
- Support to use Quality Improvement (QI) to help them understand the problem, develop, and test change ideas, measure over time the impact and develop implementation plans
- Support to meaningfully co-produce their work with service users.
- Access to a dashboard developed by informatics around Inpatient Quality and Safety to help know if change is resulting in an improvement
- Be brought together at regular learning sessions to share ideas and learn together
- Support to share the story of their work widely
Therapeutic Engagement & Observations
Teams from across every part of the trust are working to make wards a more therapeutic place for service users to be. A therapeutic environment, with meaningful engagement can have positive effects for both staff and service users. An important part of this work is focusing on improving the completion of observations in order to keep service users safe.
You can hear from staff at Mile End Hospital in Tower Hamlets, about their work on improving engagement and observations below.
You can find a collection of stories about this work by following the link here.
Teams worked to develop and test a range of change ideas, with three key ones being tested for scale up under different conditions across the trust. These include
- A board relay, where staff hand over a physical board with observation documentation
- Zonal observations, where nursing staff are assigned a zone to engage with service users
- The use of Life Skills recovery workers on Twilight shifts (2 – 10pm) to conduct therapeutic activities with service users.
Below you can hear the thoughts of staff who have been working to try these ideas in their local context
Staff at the site who originally developed and tested the change idea also produce some standard guidance to help other wards test this in the way it was designed. The guidance for these ideas can be found in the related resource section below.
ELFT Safety Culture Bundle
In working to strengthen the use of the safety culture bundle, teams are building on the success of work to reduce violence on inpatient wards carried out between 2014-2019 at ELFT. The bundle is made up of four parts: the safety cross, safety huddle, community meetings and the Brosset Violence checklist.
As part of this work the trust saw a 31% reduction in incidents of physical violence. You can learn more about this work by watching this video below (video to be embedded) and reading this article
Standard Guidance for Engagement and Observation Change Ideas
This is useful for sharing just this resource rather than the whole collection