The winners were announced at an awards ceremony held on 4 July in Manchester. The awards were a great evening of national recognition and a celebration of excellence in practice and delivery of patient safety initiatives.
The team at Cygnet Hospital Beckton led by Dr. Kanny Olojugba, Head of Psychological Services, won the award for their ‘Self-Harm to Together Healing’ programme. The programme was introduced over four years ago after the hospital had undergone a change in services from a mixed forensic service to a female specific service primarily supporting service users with a high risk of harm to self.
“The judges felt this was an excellent presentation, delivered with clear passion and drive. There was a very clear pathway of process and boundaries. A whole service approach was utilised including collaboration with service users.”Patient Safety Awards
Former harm reduction strategies focused primarily on violence to others, therefore, Senior Managers agreed that a change in policy would be insufficient and recognised the need for a culture change.
The aim of the programme was to equip staff, service users and the service with a framework by which to understand and support distress evidenced by a reduction in self-harm by ligature, cutting and swallowing (LCS) by 10%.
The findings of the preliminary studies highlighted a number of individual and environmental factors as risk factors for self-harm including the ratios of non-permanent and permanent staff per shift, proximity to admission date and service user involvement in their risk management.
Following this, the resulting initiatives included:
- Responsive Training Strategy
- NICE Guideline informed therapeutic care-pathway
- Monitoring System for the use of bank and agency staff
- Admission plan for those identified as high risk of self-harm-LCS
- Maintenance team review of risks and hazards within the physical environment
Since being introduced the programme has resulted in and maintained a 74 per cent reduction in self harm over four years with no increase in other behaviours. Thus, suggesting that the results are a true reflection of a culture change in the management of distress.
Furthermore, service users reported a 45.5% and 41.7% increase in confidence and knowledge respectively in how to manage their own distress and staff reported a 45% and 63% increase in the same, regarding the Support and Management of distress.
There was an improvement in use of understanding of established policies, 95% of staff felt more confident in using the knowledge that they had and the use of Special Nursing hours (enhanced observation) reduced by 53.3 %.
By focusing on self-harm, the ultimate aim was to reduce the likelihood of death, accidental or otherwise, during a troubled time in a person’s life.
If a service user’s life threatening behaviour is managed early into their admission, they are able to focus on other areas of recovery earlier in a safe environment thus increasing quality of life and reducing length of stay in hospital.
The project also supported the structure within Cygnet Hospital Beckton which enables it to manage more complex self-harm presentations and thus be able to offer a service to a broader range of service users who otherwise would have struggled to obtain the help that they require.
“To have national recognition for all the hard work and effort we have put into this programme is a huge boost to our work. It will certainly motivate us to maintain our focus and remain creative in our efforts to reduce incidents of self-harm.”Dr Kanny Olojugba, Head of Psychology, Cygnet Hospital Beckton