A new paradigm for mental-health quality and safety: are we ready?

Short, Brooke; Marr, Carrie; Wright, Murray

doi:10.1177/1039856218797423

Cited by 5 publications

(14 citation statements)

References 12 publications

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“…All 52 studies were classified using the MMAT as follows: two Quantitative Randomised [ 31 , 48 ] eight Quantitative Non-randomised [ 36 , 42 , 45 , 48 , 50 , 55 , 64 , 74 , 79 ], fourteen Quantitative Descriptive [ 37 , 43 , 49 , 51 – 54 , 57 , 61 , 62 , 70 , 72 , 73 , 76 ], nine Qualitative [ 33 – 35 , 39 , 41 , 56 , 58 , 59 , 66 ], and five Mixed Methods [ 30 , 44 , 60 , 63 , 71 ]. Fourteen studies (all grey literature) could not be classified using MMAT as they used a selection of quality improvement designs including four which used PDSA cycles [ 38 , 40 , 65 , 69 ], seven used other QI methods [ 32 , 46 , 47 , 67 , 68 , 77 , 81 ] and in three studies the methodology was unclear [ 76 , 78 , 80 ].…”

Section: Resultsmentioning

confidence: 99%

“…Studies were classified according to their principal focus. Almost two-thirds of studies (n = 33 focused on reducing restrictive practices [ 31 , 34 , 37 – 43 , 46 , 47 , 49 – 51 , 54 – 57 , 59 , 62 , 65 – 67 , 70 , 77 – 79 , 81 ]-[ 53 , 58 , 73 , 75 , 80 ]. Of these, 22 were from the published literature [ 31 , 36 – 43 , 46 , 47 , 49 – 51 , 53 – 59 , 62 ] and 11 were from the grey literature [ 66 , 67 , 70 , 73 , 75 , 77 – 81 ].…”

Section: Resultsmentioning

confidence: 99%

“…Almost two-thirds of studies (n = 33 focused on reducing restrictive practices [ 31 , 34 , 37 – 43 , 46 , 47 , 49 – 51 , 54 – 57 , 59 , 62 , 65 – 67 , 70 , 77 – 79 , 81 ]-[ 53 , 58 , 73 , 75 , 80 ]. Of these, 22 were from the published literature [ 31 , 36 – 43 , 46 , 47 , 49 – 51 , 53 – 59 , 62 ] and 11 were from the grey literature [ 66 , 67 , 70 , 73 , 75 , 77 – 81 ]. Most (n = 22) were evaluated as involving patients at a medium level of involvement [ 31 , 36 , 38 , 41 , 46 , 47 , 49 – 51 , 53 , 55 , 57 , 59 , 62 , 65 , 67 , 70 , 75 , 78 – 81 ].…”

Section: Resultsmentioning

confidence: 99%

“…Of these, 22 were from the published literature [ 31 , 36 – 43 , 46 , 47 , 49 – 51 , 53 – 59 , 62 ] and 11 were from the grey literature [ 66 , 67 , 70 , 73 , 75 , 77 – 81 ]. Most (n = 22) were evaluated as involving patients at a medium level of involvement [ 31 , 36 , 38 , 41 , 46 , 47 , 49 – 51 , 53 , 55 , 57 , 59 , 62 , 65 , 67 , 70 , 75 , 78 – 81 ]. Five reported engaging patients at a high level of involvement [ 37 , 43 , 66 , 73 , 77 ] and six at a low level [ 39 , 40 , 42 , 54 , 56 , 58 ].…”

Section: Resultsmentioning

confidence: 99%

“…Of those studies focusing on restrictive practices, reference was made to eight different interventions: two studies used ‘No Force First’ (NFF) [ 38 , 50 ]; five used ‘Safewards’ [ 31 , 36 , 41 , 62 , 77 ]; five used ‘6 core strategies’ [ 43 , 47 , 55 , 57 , 79 ]; three used debriefing [ 53 , 56 , 65 ]; three used framework development [ 40 , 46 , 66 ]; five used a patient safety/involvement tool [ 39 , 67 , 75 , 78 , 81 ]); three used sensory modulation [ 42 , 54 , 70 ] and seven used patient input into clinical practice/staff training [ 37 , 49 , 51 , 58 , 59 , 73 , 80 ]. Of the remaining 19 studies, six focused on general safety [ 30 , 33 , 61 , 63 , 68 , 72 ], five on self-harm/suicide [ 44 , 48 , 52 , 71 , 74 ], four on violence toward others [ 32 , 60 , 64 , 69 ], three on emotional/psychological safety [ 34 , 45 , 76 ], and one on sexual safety [ 35 ].…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

To what extent are patients involved in researching safety in acute mental healthcare?

Brierley-Jones

Ramsey²,

Canvin

et al. 2022

Res Involv Engagem

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Background There is a growing need to involve patients in the development of patient safety interventions. Mental health services, despite their strong history of patient involvement, have been slow to develop patient safety interventions, particularly in inpatient settings. Methods A systematic search was undertaken of both academic and grey literature. Whilst no lay member of the team worked directly on the review, they were part of the project steering group which provided oversight throughout the review process. This included people with lived experience of mental health services. From a research perspective the main focus for lay members was in co-producing the digital technology, the key project output. Smits et al.’s (Res Involv Engagem 6:1–30, 2020) Involvement Matrix was used to taxonomise levels of patient involvement. Studies were included if they were set in any inpatient mental health care context regardless of design. The quality of all selected studies was appraised using Mixed Methods Appraisal Methodology (MMAT). Results Fifty-two studies were classified, synthesised and their levels of patient involvement in the research and development of patient safety interventions were taxonomised. Almost two-thirds of studies (n = 33) researched reducing restrictive practices. Only four studies reported engaging patients in the research process as decision-makers, with the remaining studies divided almost equally between engaging patients in the research process as partners, advisors and co-thinkers. Just under half of all studies engaged patients in just one stage of the research process. Conclusion Involvement of patients in researching patient safety and developing interventions in an inpatient mental health context seems diverse in its nature. Researchers need to both more fully consider and better describe their approaches to involving patients in safety research in inpatient mental health. Doing so will likely lead to the development of higher quality safety interventions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

To what extent are patients involved in researching safety in acute mental healthcare?

Brierley-Jones

Ramsey²,

Canvin

et al. 2022

Res Involv Engagem

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Patient Safety Strategies in Psychiatry and How They Construct the Notion of Preventable Harm: A Scoping Review

Svensson

2021

J Patient Saf

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Objectives:The literature on patient safety in psychiatry has not been explored systematically in terms of what interventions are used, how they are used, and what type of (preventable) harm is targeted. The aims of this scoping review are to explore patient safety strategies used in psychiatry and determine how they construct the notion of preventable harm. Method:A scoping review of literature on patient safety in psychiatry published in English between 2000 and 2019 was conducted using Scopus, MEDLINE, PsycInfo, and CINAHL. Keywords of patient safety strategies and possible outcomes were coded from the results, discussion, or conclusion. Patient safety strategies were inductively categorized into themes according to the focus of the strategy. Results:The review introduces 7 focus areas of patient safety strategies identified within the psychiatric literature: "risk management," "healthcare practitioners," "patient observation," "patient involvement," "computerized methods," "admission and discharge," and "security." The result shows that patient safety strategies mainly aim to reduce suicide, self-harm, violence, and falls and present a large diversity of measures, often aimed at reducing variability while increasing standardization. Conclusions:The strategies that are supported in the literature to achieve safer psychiatry mainly arise from linear cause-effect models and rely on staff performance, competence, and compliance. Contemporary safety science acknowledges the performance variability of everyday normal work and sees risk as the dynamic migration of these daily activities. The field of psychiatry has not yet included this view of safety in the strategic actions to reduce preventable harm.

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Conceptual and practical challenges associated with understanding patient safety within community‐based mental health services

Averill

Vincent

Reen

et al. 2022

Health Expectations

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Patient safety problems stemming from healthcare delivery constitute a global public health concern and represent a pervasive barrier to improving care quality and clinical outcomes.However, evidence generation into safety in mental healthcare, particularly regarding community-based mental health services, has long fallen behind that of physical healthcare, forming the focus of fewer research publications, and developed largely in isolation from the wider improvement science discipline. We argue that this disconnect yields, and is likely the product of, both conceptual and practical difficulties which must be overcome to advance the science and improvement of safety in mental health services. Drawing upon theoretical and empirical evidence from the fields of mental healthcare, patient safety, and improvement science, challenges encountered in our efforts to understand patient safety problems in community-based mental health services, a particularly unmapped area of safety, are described. We consider the origins of these issues and their probable implications for patient safety science and clinical care. Challenges in defining safety in the context of community mental healthcare, establishing what constitutes a 'preventable' safety problem, and the available evidence, are outlined. The dominant risk management approach to safety in mental healthcare, which positions service users as the origin of risk, has seemingly prevented a focus on proactive safety promotion, considering iatrogenic harm and latent system hazards. We propose a wider conceptualisation of safety and discuss important next steps for the integration and mobilisation of disparate sources of 'safety intelligence', to advance how safety is conceived and addressed within community mental healthcare.

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A new paradigm for mental-health quality and safety: are we ready?

Cited by 5 publications

References 12 publications

To what extent are patients involved in researching safety in acute mental healthcare?

To what extent are patients involved in researching safety in acute mental healthcare?

Patient Safety Strategies in Psychiatry and How They Construct the Notion of Preventable Harm: A Scoping Review

Conceptual and practical challenges associated with understanding patient safety within community‐based mental health services

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