Violence Reduction Collaboratives in Newham and City & Hackney

Newham and City & Hackney Inpatient units have been working since early 2016 to reduce violence and aggression on the inpatient wards, building on the work of the Tower Hamlets Violence Reduction Collaborative. Sustained reductions in violence are now being experienced in both services, with reductions of up to 86% linked to the project on some wards.

The wards and Psychiatric Intensive Care Units (PICUs) have been working hard to reliably use change ideas from Tower Hamlets, including for example Safety Huddles, which are brief stand-up meetings during which as many staff as possible from the ward come together to try to identify and predict risks and then develop plans for how to manage these risks together.

Both units have developed creative ways to boost the reliability of using their change ideas, including the Newham Reliability Race and the City and Hackney Safety-Huddle-o-Meter (see figures 1 and 2). Along with ward-level strategies, these visual displays help to raise awareness across the units and foster friendly competition between the wards!

Figure 1 – The Newham Reliability Race

Figure 2 – The City and Hackney reception display, complete with Safety-Huddle-O-Meter!

Violence and aggression obviously has a profound effect on inpatient settings, compromising our service users’ care and staff experience at work. The hard work and courage of staff in City and Hackney and Newham to share and learn together in their local violence reduction collaboratives, is now changing the systems people are working in and transforming experience. This is reflected in recent comments from staff and peer support volunteers, which you can read in in figures 3 and 4 below, as well as the collaboratives’ numeric data, shown in figure 5.

Figure 3 – City & Hackney feedback

Figure 4 – Newham feedback

Figure 5 – Reductions we are seeing in our data over time

Reducing  violence and aggression isn’t easy –  and we know we’ve got a lot more learning to do together – but we’re very excited by all that has been achieved so far.

We’re looking forward to the further learning and reductions to come in 2017!

The Forensic service has also launched its own violence reduction collaborative, with the support of the QI team, developing an understanding of the unique drivers of violence and solutions within forensic settings. This will be featured in a future newsletter.