1 / 11

Refocusing Acute Psychiatry: 10 Years on

Refocusing Acute Psychiatry: 10 Years on. Nick Bowles Consultant Nurse and Freelance Trainer. Refocusing. A “big idea” and an organising framework Model for Practice Development Change Management Programme. Impact. Implemented in 14 NHS Trusts and 7 Irish Hospitals

fritzi
Download Presentation

Refocusing Acute Psychiatry: 10 Years on

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Refocusing Acute Psychiatry: 10 Years on Nick Bowles Consultant Nurse and Freelance Trainer Contact Nick Bowles on: preferredfutures@gmail.com

  2. Refocusing • A “big idea” and an organising framework • Model for Practice Development • Change Management Programme Contact Nick Bowles on: preferredfutures@gmail.com

  3. Impact • Implemented in 14 NHS Trusts and 7 Irish Hospitals • Significant contributor to DH Acute Policy • Anticipated & popularised key elements of current practice Contact Nick Bowles on: preferredfutures@gmail.com

  4. Refocusing Origins • Field Site: Bradford 1999 to 2002 • Theoretical Basis: Work Strain Theory Appreciative Inquiry Reflexivity (shared environment & dynamics) Contact Nick Bowles on: preferredfutures@gmail.com

  5. Work Strain Theory (Robert Karasek, Univ. Mass.) Contact Nick Bowles on: preferredfutures@gmail.com

  6. Appreciative Inquiry • Solution Focused • Asks “what works” & “how can we do more of it” • Envisions “Preferred Futures” that people really want Contact Nick Bowles on: preferredfutures@gmail.com

  7. Refocusing Elements Contact Nick Bowles on: preferredfutures@gmail.com • Purposeful admission (reduced bed occupancy; length of stay) • Collaboration and co-operation; goal setting and goal matching; shared safety and risk management • Increased engagement; daily one to one; standards for KW role • Solution Focused approaches from nurses & support staff (we train) • Structured day with meaningful activities; “Protected Time” every day • Highly visible nurses (out of the office) • Reduced or stopped formal arms length and intermittent observation • Line management supervision for all staff that is evidence based • Information literacy & performance management culture (“dashboard”) • Leadership Development (incl. 360 degree system)

  8. Refocusing Results • Increased safety, reduced violence, aggression, SUI, AWOL • Reduced LoS, OBD, RA30 • Reduced staff sickness, overtime and bank spending • Reduced risks to all, including litigation • Fitness for purpose, service acceptability Contact Nick Bowles on: preferredfutures@gmail.com

  9. Reflections on Last 10 yrs • All “systems” can change despite pessimism • Whole system and whole team approaches work • Refocusing anticipated national change in in-pt psych and is widely imitated (Star Wards; Lean; Productive Ward) • Acute wards have improved massively (CQC, 2009) and alternatives to admission have come on-stream • Time now for critical re-appraisal of Acute In-Patient role (i.e. what and who is it for, are there better alternatives) Contact Nick Bowles on: preferredfutures@gmail.com

  10. The next 10 Years • Recovery to be the dominant paradigm, not illness • Lost public confidence in pharmaceutical evidence will drive alternatives (substances & services) • Backlash to CTO’s unless there is a paradigm shift • Disinvestment in secondary and centralist services • Increased role for Third Sector and non-psych staff • Increased proportion of generic workers • Increased role for alternatives to admission (could we ever follow the Lille Model? Why not?) Contact Nick Bowles on: preferredfutures@gmail.com

  11. Finally… • Acute Wards have changed… • Now they (staff, prosumers, community) need to evolve Contact Nick Bowles on: preferredfutures@gmail.com

More Related