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How Do Patients, Carers and Mental Health Nurses Experience Their Contact With the Forensic Multidisciplinary Team in a Medium-Secure Unit? a Thematic Analysis
- Alexander Jack, Eleanor Parkinson, Talhah Malik, Stephen Hemblade, Fiona Hynes
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- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, p. S52
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Aims
Clinical teams oversee the care of patients within secure psychiatric inpatient settings. They are made up of a number of professions, including psychiatrists, psychologists, occupational therapists, social workers and nurses. The effective collaboration of the different members of the clinical team is vital for its functioning. However, so is the team's interface with other key stakeholder groups, namely nursing teams, service users and carers. Understanding the needs and priorities of these groups regarding their relationships with the clinical team is also important to recognise and in the provision of good quality care. To understand the experiences, priorities and needs of stakeholder groups in their relationship with the clinical team. Gaining feedback from multiple sources (service users, carers, nurses) will help facilitate functioning of the clinical team in the delivery of excellent care to service users.
MethodsEthical approval was granted by the host NHS trust. Between October 2019 and October 2021, three focus groups were conducted using a semi-structured interview to gather responses from carers, nurses and service users (6 participants in each group) respectively. The interviews were recorded and transcribed. Thematic analysis was used to code each transcript and themes were drawn from the coded data.
ResultsDominant themes emerged from the three data sets. Consistent themes between groups included communication, hierarchy/power and representation. There were also differences in themes identified, with the carer group bringing the theme of education/ knowledge, and nursing group raising the value of human relationships, including compassion. The theme of transparency emerged strongly for the service user group.
ConclusionThis study offers an interesting perspective on what distinct stakeholder groups want and value in their relationship with the clinical team. Gaining feedback from multiple sources (service users, carers, nurses and members of the MDT) can better inform a team about its functioning and help improve performance. Developing a tool to aid the systematic collection of multi-source feedback is the next step of this project, facilitating the voices of key stakeholder groups to be heard.
What Do Secure Care Stakeholders Want From the Forensic MDT? a Qualitative Study With Service Users, Carers, and Nurses
- Fiona Hynes, Alexander Jack, Eleanor Parkinson, Steven Hemblade, Talhah Malik
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- Journal:
- BJPsych Open / Volume 8 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 20 June 2022, p. S65
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- Article
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- You have access Access
- Open access
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Aims
Clinical teams oversee the care of patients within secure psychiatric inpatient settings. They are made up of a number of professions, including psychiatrists, psychologists, occupational therapists, social workers and nurses. The effective collaboration of the different members of the clinical team is vital for its functioning. However, so is the team's interface with other key stakeholder groups, namely nursing teams, service users and carers. Understanding the needs and priorities of these groups regarding their relationships with the clinical team is also important to recognise and in the provision of good quality care. This study aims to understand the experiences, priorities and needs of stakeholder groups in their relationship with the clinical team. Gaining feedback from multiple sources (service users, carers, nurses) will help facilitate functioning of the clinical team in the delivery of excellent care to service users.
MethodsEthical approval was granted by the host NHS trust. Between October 2019 and October 2021, three focus groups were conducted using a semi-structured interview to gather responses from carers, nurses and service users (6 participants in each group) respectively. The interviews were recorded and transcribed. Thematic analysis was used to code each transcript and themes were drawn from the coded data.
ResultsDominant themes emerged from the three data sets. Consistent themes between groups included communication, hierarchy/power and representation. There were also differences in themes identified, with the carer group bringing the theme of education/ knowledge, and nursing group raising the value of human relationships, including compassion. The theme of transparency emerged strongly for the service user group.
ConclusionThis study offers an interesting perspective on what distinct stakeholder groups want and value in their relationship with the clinical team. Gaining feedback from multiple sources (service users, carers, nurses and members of the MDT) can better inform a team about its functioning and help improve performance. Developing a tool to aid the systematic collection of multi-source feedback is the next step of this project, facilitating the voices of key stakeholder groups to be heard.
Improving Access and Confidence in Learning Lessons From Serious Incidents: A Quality Improvement Project Aimed at Junior Doctors
- Cornelia Beyers, Eleanor Parkinson, Rajendra Harsh, Sameer Nardeosingh, Dolapo Oseji, Alice Packham, Nick Conway, Renarta Rowe, Ruth Scally, Joshua Rochelle-Bates, Onaiza Awais, Farhaana Surti
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- Journal:
- BJPsych Open / Volume 8 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 20 June 2022, p. S87
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Aims
Birmingham and Solihull Mental Health Foundation Trust (BSMHFT) previously developed some methods of learning lessons following serious incidents. However, despite various systems available, frontline junior doctors were not regularly exposed to important learning opportunities. This potentially resulted in doctors not being aware of learning from serious incidents, and not feeling embedded within the organisation, with potential effects on their training experience. As we identified an unmet need within the Trust in learning lessons from serious incidents amongst junior doctors, we aimed to improve access and confidence in learning from serious incidents by starting a Quality Improvement project on this theme.
MethodsThe current approach involved a comprehensive quarterly bulletin circulated by email to staff. An initial survey confirmed that this was not very effective in delivering learning lessons information to junior doctors.
Using a QI driver diagram, we identified potential areas for change. Selected change ideas were sequentially trialled including shortened email bulletins, supervision templates and remote learning lessons sessions. Initial PDSAs highlighted difficulties with communication via email, with many trainees failing to read/engage with this format.
ResultsThe use of remote interactive learning sessions yielded positive results, with improvement in the confidence in learning from Serious incidents. We therefore continued to refine this method to wider groups.
During the COVID-19 pandemic we experienced multiple setbacks and created a timeline tosupport team morale, maintain team energy, visualise progress and motivate the team. We therefore managed to persevere and strengthened the group by recruiting members to the team and complete the project.
ConclusionThe team have been able to create a sustainable, effective and interactive short teaching session which has shown to be effective in engaging trainees in this vital area and help us meet our aim. This format further has the potential to be refined and implemented locally and nationally.
West Midlands region less than full time training survey
- Eleanor Parkinson, Fiona Hynes
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- Journal:
- BJPsych Open / Volume 7 / Issue S1 / June 2021
- Published online by Cambridge University Press:
- 18 June 2021, p. S151
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Aims
To more fully understand the training experience of less than full time (LTFT) trainees working in psychiatry in the West Midlands Region with the aim of identifying areas that would improve the training experience.
BackgroundLTFT training has grown in popularity since its formal introduction in 2007. The greater participation of women in medicine and generational changes in lifestyle expectations are some of the factors behind this trend. Approximately 13% of psychiatry trainees in the UK are training LTFT, bringing the benefit of allowing trainees to balance caring responsibilities or health conditions with continuing their postgraduate training. However it is not without its challenges for trainees which we aimed to explore in this survey.
MethodAn electronic survey was sent out to all trainees via email, LTFT trainees of all training grades were invited to respond. Trainees were contacted in the five mental health trusts making up the region. The survey contained 32 questions that covered a range of topics including educational opportunities, perceived attitudes to LTFT trainees and training experience. Data were collected over a six month period in 2019. There were 22 responses to the survey region-wide.
Result86% of respondents were working reduced sessions in full-time posts with implications for their clinical workload and 14% responded that their clinical contact time was not adjusted to reflect their working hours. 36% of respondents experienced difficulties attending their formal teaching programme while 82% had attended educational commitments on non-working days. 14% of respondents felt training LTFT did not allow them to meet training requirements while 23% would not recommend LTFT training in the West Midlands to others. Trainees cited difficulties managing a full time workload and not having support from supervisors as reasons for these views. 40% of respondents reported experiencing negative attitudes from seniors and 50% felt isolated from other trainees due to LTFT training status.
ConclusionThe survey has developed our understanding of the challenges faced by LTFT trainees and it has been communicated regionally and to employing trusts to promote action. For example, at a trust level, the use of personalised work schedules can address some common difficulties. More effectively communicating sources of support to trainees, sharing best practice and providing networking opportunities are suggested as next steps regionally. New administrative processes to maintain an accurate list of LTFT trainees is vital in implementing this. Improving the information given to trainers is another development area.