Absconding: reducing failure to return in adult mental health wards

Failing to return from leave from acute psychiatric wards can have a range of negative consequences for patients, relatives and staff. This study used quality improvement methodology to improve the processes around patient leave and time away from the ward. The aim of this study was to improve rates...

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Main Authors: Bailey, J, Page, B, Ndimande, N, Connell, J, Vincent, C
Format: Journal article
Published: BMJ Publishing Group 2016
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author Bailey, J
Page, B
Ndimande, N
Connell, J
Vincent, C
author_facet Bailey, J
Page, B
Ndimande, N
Connell, J
Vincent, C
author_sort Bailey, J
collection OXFORD
description Failing to return from leave from acute psychiatric wards can have a range of negative consequences for patients, relatives and staff. This study used quality improvement methodology to improve the processes around patient leave and time away from the ward. The aim of this study was to improve rates of on-time return from leave by detained and informal patients by 50%. Following a baseline period, four interventions were implemented and refined using PDSA cycles. The main outcome measure was the proportion of periods of leave where the patient returned on time. Late return was defined as failure to return to the ward within 10 minutes of the agreed time. At baseline, the rate for on-time return was 56.0%; this increased to 87.1% post-intervention, a statistically significant increase of 55.5%. SPC charts show that the interventions were associated with improvements. The improvements have been sustained and the interventions are fully embedded into daily practice. The project was refined to local context and trialled on six additional wards: four of the six wards have successfully implemented the interventions and have on-time return rates of over 90%. This project produced a marked and sustained improvement in patients returning on-time from leave, facilitating a more open discussion between staff and patients about the purpose and value of periods away from the ward. Quality improvement approaches can be effectively applied in mental health settings.
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spelling oxford-uuid:cf3c074c-aec7-4d18-a616-f54767e458332022-03-27T07:41:06ZAbsconding: reducing failure to return in adult mental health wardsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:cf3c074c-aec7-4d18-a616-f54767e45833Symplectic Elements at OxfordBMJ Publishing Group2016Bailey, JPage, BNdimande, NConnell, JVincent, CFailing to return from leave from acute psychiatric wards can have a range of negative consequences for patients, relatives and staff. This study used quality improvement methodology to improve the processes around patient leave and time away from the ward. The aim of this study was to improve rates of on-time return from leave by detained and informal patients by 50%. Following a baseline period, four interventions were implemented and refined using PDSA cycles. The main outcome measure was the proportion of periods of leave where the patient returned on time. Late return was defined as failure to return to the ward within 10 minutes of the agreed time. At baseline, the rate for on-time return was 56.0%; this increased to 87.1% post-intervention, a statistically significant increase of 55.5%. SPC charts show that the interventions were associated with improvements. The improvements have been sustained and the interventions are fully embedded into daily practice. The project was refined to local context and trialled on six additional wards: four of the six wards have successfully implemented the interventions and have on-time return rates of over 90%. This project produced a marked and sustained improvement in patients returning on-time from leave, facilitating a more open discussion between staff and patients about the purpose and value of periods away from the ward. Quality improvement approaches can be effectively applied in mental health settings.
spellingShingle Bailey, J
Page, B
Ndimande, N
Connell, J
Vincent, C
Absconding: reducing failure to return in adult mental health wards
title Absconding: reducing failure to return in adult mental health wards
title_full Absconding: reducing failure to return in adult mental health wards
title_fullStr Absconding: reducing failure to return in adult mental health wards
title_full_unstemmed Absconding: reducing failure to return in adult mental health wards
title_short Absconding: reducing failure to return in adult mental health wards
title_sort absconding reducing failure to return in adult mental health wards
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AT pageb abscondingreducingfailuretoreturninadultmentalhealthwards
AT ndimanden abscondingreducingfailuretoreturninadultmentalhealthwards
AT connellj abscondingreducingfailuretoreturninadultmentalhealthwards
AT vincentc abscondingreducingfailuretoreturninadultmentalhealthwards