QI 73 Reducing Restrictive Practice - November 2018 to April 2020

Abstract

Aim: To reduce the overall use of restrictive practice by 30% by April 2020. This project was run by RCPSYCH and included 40 wards across the country, focussing on Improving Mental Health Safety. Rowans was identified as a target ward to be included and was supported by a QI Coach from the RCPSYCH.

We created a Driver Diagram to help focus change ideas into themes Leadership and Learning Culture, Co-Production, Environment, Prevention and Predication and Person Centred Care. We identified how we would collect data and display progress, using a safety cross and incident reporting data, and we used a collaborative approach, including patient involvement, to generate ideas to implement and test using the PDSA cycle.

Tools Used: Driver Diagram - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-driver-diagrams.pdf. PDSA Cycle - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-pdsa-cycles-model-for-improvement.pdf. Statistical Process Control (SPC) chart - www.england.nhs.uk/statistical-process-control-tool.

Project Impact: Staff and patients identified communication and trust was improved. The staff team felt more motivated. The team feel less stressed and able to focus on being creative with the client group and developing interpersonal relationships. The patients felt that the interventions have been empowering.

Overall data showed a 55% reduction. Physical restraint saw a 57% reduction and rapid tranquilisation became in line with normal variation.