Reducing Failure to Return from Leave or Agreed Time Away

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Caring safe and excellent,Drivers for Change I,The consequences of absconding can be. catastrophic between 1997 and 2011 24 of all,inpatient suicides in England occurred following. absconding from the ward leaving without,permission. Two local serious incidents,Relationships with Police. Caring safe and excellent,Drivers for change II,Patients who are absent from hospital may also.
suffer physical harm,care and treatment is often disrupted. ward teams become anxious time is used completing searches. and following procedures,Police time and resource is taken. the relationship with families and carers can deteriorate. Stewart Bowers 2010 Bowers 2013,Caring safe and excellent. Diagnostics, Incidence of absconding low Failure to return demanded attention. Pilot Ward Baseline Data showed mean 30 patients returning on. time over 6 week period,Managed leave periods 150 220 times per week.
Care Systems,Legal framework MHA 1983, S17 leave arrangements lacked collaboration with patients. Misunderstanding of potential risks associated with informal. Caring safe and excellent,Diagnostics,Care Process. High variability in adherence to legal framework local. policy process mapping,Both patients and nurses were vulnerable. Patients became stigmatised for poor adherence to an. incomprehensible system, Security vs care culture emerged through the mapping. Caring safe and excellent,Aim Ward A pilot ward, To reduce failure to return to the ward by detained.
and informal patients by 50 by 31st May 2015,Caring safe and excellent. Agree Measure Definition,Any inpatient detained or informal who fails to. return to the ward later than 10 minutes over the,leave period that was agreed and documented by. ward staff and who has not made contact with the,ward to agree a later return time. Caring safe and excellent,Tasks of change,Engage teams Pilot then refine and adopt.
Train in IHI methodology and measurement for improvement. inc Baseline software Weekly data collection and review. Engage patients with each test through community meetings. Work with CQC to explore current perceptions of informal. Agree ward expectations,approve design of information leaflet. Engage with Communications Team to standardise information. posters across wards, Local policy reviewed to standardise 10 minute searching period. within care process governance process,Caring safe and excellent. Leaflet for detained and informal patient,Set out ward expectations for informal patients. Medication times,Meetings with Named Nurse,Participation in agreed therapeutic activities.
Ward reviews with MDT, Set out the steps that will be taken should the patient fail to. return or fail to contact,Caring safe and excellent. Informal patients and time away from hospital,Going on leave. While you are an inpatient we,have a duty of care to support. you in maintaining your safety at,all times We want your leave to.
go well and for you to return,safely We will provide you with. a card with the ward address,and telephone numbers before. you go on leave so that you can,easily contact us in the event of. a problem We ask that when,you take time away from the. ward you let us know of your plans and when you intend to. It is important that if you are delayed in returning for any. reason you contact the ward immediately so that we can. discuss how you plan to return safely, Informal patients and If we do not hear from you staff will try to contact you your.
family or your friends If we become very concerned for your. safety we may contact the police, time away from hospital If at any time you feel unable to agree to these expectations. please discuss this with us we will consider other options of. continuing care and treatment to support your recovery. Caring safe and excellent,Tests of Change PDSAs,Cycle 5 Introduce intentional rounding. S D Cycle 4 Introduce leaflets designed in,collaboration with CQC with patient artwork. Cycle 3 Introduce cards designed with patients and. display posters with message of care and staff,A P prompts. S D Cycle 2 Introduce documented leave planning form to inform. ward reviews, Cycle 1 Introduce signing in and out book data collection tools.
Caring safe and excellent,Enhanced reliability and safety in the. care process,Caring safe and excellent,Ward A Year 2. Caring safe and excellent,Ward B Acute year 1,Caring safe and excellent. No of leave episodes on Ward B,Introduction of smoking ban.

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