Improving the quality of carer contact on Jade Ward

 6th April 2022

By Sean Stone, Life Skills Recovery Coordinator, Jade Ward, East London NHS Foundation Trust.

In this 3-minute read, hear about the improvement work being done on Jade Ward, a Psychiatric Intensive Care Unit (PICU) in Luton to improve the quality of carer contact.  Jade ward is a specialist unit that provides inpatient mental health care, assessment and comprehensive treatment to individuals who are experiencing the most acutely disturbed phase of a serious mental disorder. This was originally published in the Quality Network for Psychiatric Intensive Care Units newsletter in December 2021. You can access the original newsletter story here.

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With regards to mental health, anecdotal evidence perceives that Psychiatric Intensive Care Units (PICU) can by default be potentially restrictive. Patients need to be compassionately cared for in secure environments with safety restrictions that are evidence based informed by policy and guidelines.  Furthermore, the ongoing Covid-19 pandemic has further led to restrictions that meant people are even more so cut off from loved ones than they were before. Both truths applied to detained service users, meant that access to their relatives, friends and loved ones was made harder. Despite the advances in technology that facilitate communication, which everyone has had to adapt to, the limitations of technology, individual circumstances and the restrictions have meant that the point of contact that can bridge the two has been the nursing team of their PICU. They, in addition to duties and responsibilities, keep the carer updated (albeit where allowed) on the care of the service user.

Problem:

Given the high workload on PICU due to the complex care needs and closer monitoring of patients, it can regrettably occur that the carer contact can be missed or fall short of what is expected. On Jade Ward PICU in Luton we have strived to improve upon that issue by carrying out a ward-based quality improvement (QI) project regarding the quality of carer contact with a multi-disciplinary team approach. As it is a QI project, it is ever evolving and receptive to feedback, some which is already helping us to achieve our aim.

Project aim:

“To increase the quality of carer consultations on Jade ward by 20% by March 2022”.

Drawing on the minds of different members of an inpatient ward and collaborating with service user input, with valuable input coming from a past carer, we were able to come up with several change ideas to enact to improve the quality of carer contact.

Change ideas:  

One of the changes made was circulating a welcome letter for the carers of newly admitted or transferred service users that clearly and concisely informs the carer about the ward and how it operates. This includes the information relevant to what a carer might need to know. Much like how a new service user would be given a welcome pack that informs them about the ward, a similar resource is now available to the carers. Previously, carers would have to rely on direct contact with the ward or what they could source on the official website.

Another change surrounds the initial contact with the carer. Good practice would typically dictate that a carer be informed within 24 hours of the service user’s admission. However, based on what was fed back to us by the service user/carer representative, it was determined that the ward should contact the carer within 6 hours of admission. They might have been admitted for a mental health crisis, it can be distressing for the carer not to know what has happened to them and to have reassurance come sooner rather than later can make all the difference.

Tied to that is also asking the carer when a good time to contact them would be, to maintain continuity of contact. It goes without saying that carers have their own lives and with it their demands on them, so to alleviate any inconvenience or missed opportunities for contact, staff can be ready and organised to contact the carer.

As for the current quality of carer contact as perceived by our current carers, the results are positive figure 1 showing a preliminary finding of a 2% improvement in carer satisfaction (I Chart).  Carer satisfaction was rated on a scale of 1-5, where 1=Very unsatisfied, 3=Neutral and 5= Very satisfied with the service. Overall, carers highly rated the service, with no scores below 3.

Hopefully this good progress continues and if it suffers setbacks or problems, it will be met not with a sense of futility but humility and willingness to change, to continue to prosper, and, most importantly, allow the carer to be more at ease and informed.