STEPS: Successful Team Engagement in inpatient Psychiatric Services

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STEPS Successful Team Engagement in inpatient
Psychiatric Services
DR STEPHEN PEREIRA MD, FRCPsych, DPM, MSc,
MBBS Lead Consultant Psychiatrist KATE
WOOLLASTON Research Psychologist
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Introduction

• Therapeutic engagement is an intervention that
  aims to empower the patient to actively
  participate in their care involves healthcare
  professionals spending quality time with
  patients.
• Currently a lack of therapeutic engagement on
  inpatient wards

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Method

• Selection of Positive Practice Units
• Representatives from the MDTs who work in these
  units took part in focus groups
• Thematic analysis is used to code the date
  raise themes

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1. Respecting Patients

• No them and us culture
• Staff are open and honest with patients
• Patients are treated as individuals and their
  care tailored accordingly

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2. Empowering patients

• Patients are involved as much as possible in
  their own care
• Patients write care plans with staff
• Patients are consulted regarding risk assessments
• Patient meetings

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3. Staff being available

• Nurses are present approachable on the ward
• Nurses have 3 key-working sessions a week with
  their allocated patients
• Non-structured time is valued
• Staff are available to escort patients off the
  ward

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4. Engagement-focused observation

• Obs are kept to a strict minimum
• Staff explain to patients why their level has
  increased facilitate 11 sessions
• Staff engage patients in activities which are
  meaningful to them
• Patients continue to be engaged in a range of
  multi-professional activities

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5. Homely Environment

• A high standard of ward décor, furniture
  crockery is maintained
• Maximum availability of facilities within
  practical constraints
• Patients have access to a range of activities
  throughout waking hours rather than just 9-5

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6. Good tem dynamics MDT working

• The team have a shared philosophy on patient care
• There is a flattening of professional boundaries,
  in which all team members are treated as equals
  able to communicate as such
• Staff are supportive of each other

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7. Nurses nursing assistants feeling empowered

• Flattening of professional boundaries
• Support from the rest of the MDT
• Flexibility around working hours
• Regular training supervision

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8. Support information available from outside
sources

• Service user representatives advocates spend
  time on the ward
• Supporting patients facilitating communication
  with professionals

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9. Therapeutic work

• Flexible group programme, driven by patients
  needs and requests
• Ward-based OT
• Groups are facilitated by all the MDT
• Individual work

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10. Good interface between services

• Discharged patients are able to visit the unit
• Good communication exist between all clinical
  teams
• Staff visit patients if they are transferred to a
  PICU

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11. Embracing change

• All members of the MDT continually strive to
  improve the service
• Suggestions by patients staff are welcomed and
  acted upon.

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Conclusion

• Vibrant, dynamic ward culture
• Patients are respected empowered
• Staff are valued supported
• Shared vision of patient care