Executive Summary Checklist

This section includes a brief introduction of the patient safety issue followed by a list of actionable steps to improve care.

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