Executive Summary Checklist
This section includes a brief introduction of the patient safety issue followed by a list of actionable steps to improve care.
- For example, "Implement continuous electronic monitoring on all floors where patients are receiving opioid medications."
The Performance Gap
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Clinicians and Physicians in acute mental health units rely on the environment, medications and care planning to provide treatment to patients. Care planning during acute Mental Health treatment that is inclusive of the patient and other supports is vital to patient safety. Poor care planning leads to poor outcomes. When care planning is absent or incomplete, serious patient harm and/or harm to others may occur.
To empower staff to promote and increase client collaboration, there is a need for:
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Mechanisms for gaining service user feedback. Use of a Client and Family Satisfaction Survey to assess use and value of the Comfort Plan, as well as objective measures such as seclusion room use, code white frequency, and length of stay.
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Patient safety incidents in a mental health context include:
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riskto others (74%) followed by risk to self (61%) and risk of absconding (55%) (Tunde-Ayinmode et al., 2004). Up to 47% of mental health care providers have experienced violence at work (Nolan, 1999).
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delivery
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By bringing in simple, structured ways for staff to collaborate with patients, we aim to improve clinical outcomes and decrease patient safety incidents. Specifically, we propose to foster patient safety by promoting the use of a Comfort Plan (Appendix A), which is a tool for patients to work with staff on developing a proactive plan for times of acute psychiatric crisis.
Leadership Plan
- Develop a motivational interview protocol to guide staff and physicians in determining appropriate family and supports to be involved in care planning
- Develop comfort planning practices for staff to engage with patients prior to care planning.
- Develop or adopt a comfort planning model that includes X, Y, Z and specific elements of importance to your community
- Provide capacity. Protect time to engage in patient comfort planning.
- Provide capability. Educate staff on how to leverage comfort planning, how to engage patients to identify their triggers, and when to seek additional resources
- Provide motivation. Highlight the importance of patient involvement in patient outcomes, empower staff to take action to proactively assess and include patients in their treatment.
- Provide a systematic way to track and iteratively improve patient engagement. Collect data about outcomes, success rates.