Intervention:

Based on a thematic analysis of the focus

group data (Krueger & Casey 2009), and
inuenced by service priorities and time
and resource limitations, I chose and
designed an intervention for the SIP: A pilot
design for restructuring the way patient
care reviews take place around My Shared
Pathway Care Plans.
I proposed a radical restructuring of these
care plans that had been in operation for a
number of years.
This proposed intervention has been
presented to senior management to request
their approval for a pilot study.
As an outcome, I gained the agreement
of Consultant Psychiatrist, Ward manager
and senior hospital management for the
changes to be piloted on one ward within
the hospital.
Potential Impact:
My colleagues believe that as a result of
the pilot design the progression of patients
through the hospital from the point of
admission right through to discharge will
be improved and delays minimised.
The impact of this SIP has the potential
to be felt even more widely depending on
the outcomes of future evaluations and
research. For example, once the changes to
the care review process have been piloted
and evaluated, senior management could
choose to roll them out across the hospital
and even the rest of the service more
widely.
References
Brown, K. & Fahy, T. 2009. Medium secure units: pathways
of care and time to discharge over a four-year period in South
London. Journal of Forensic Psychiatry and Psychology, 20
(2), 268-277.
Coid, J. et al. 2001. Medium secure forensic psychiatry:
Comparison of 7 English health regions. British Journal of
Psychiatry, 178, 55-61.
Engel, R.J. and Schutt, R.K. 2010. Fundamentals of Social
Work Research. London. Sage.
Krueger, R. & Casey, M. 2009. Focus Groups: A Practical
Guide for Applied Research. 4th ed. London: Sage.
Linhorst, D. M. 2002. A Review of the Use and Potential of
Focus Groups in Social Work Research. Qualitative Social
Work, 1(2), 208-228.
Shah, A. et al. 2011. Factors associated with length of
admission at a medium secure forensic psychiatric unit.
Journal of Forensic Psychiatry and Psychology, 21 (2), 321-
339.
Tetley, A. et al. 2010. Difculties in the pathway from high to
medium secure services for personality-disordered patients.
Journal of Forensic Psychiatry and Psychology, 21 (2), 189-
201.
The National Centre for
Post-Qualifying Social Work
(NCPQSW)
Professional education at the National Centre
for Post-Qualifying Social Work is centred
on a commitment, passion and dedication to
develop healthcare and social work practice.
We believe that by improving the quality of
services through partnering with practitioners
and employers across the health and social
care arena we make a vital contribution to
society in general and vulnerable people in
particular.
Over 10,000 practitioners have successfully
undertaken our programmes since the year
2000 and we have won a total of 9 prestigious
teaching awards during this time.
Visit us at: www.ncpqsw.com
Context and aim:
I am seconded into the NHS as a
Social Worker in a secure psychiatric
setting.
I offer practical and therapeutic
support to patients, helping them to
progress through the hospital and
out into the community.
One challenge in this work is
the delays that patients face in
progressing through the service.
The overall aim of my SIP has been
to reduce delayed discharges in a
secure psychiatric hospital.
Literature and methods:
Current knowledge in my hospital
around possible reasons for these
delays and appropriate interventions
is limited.
The PSIP literature review conrmed
the limited nature of knowledge
around delayed discharges.
Therefore, the problem needed
better dening before interventions
(e.g. see Brown & Fahy 2009; Coid et
al. 2001; Shah et al. 2009; Tetley et
al. 2010) could be identied.
I took an enquiry-led approach to
this project using a focus group
methodology (e.g. see Engel & Schutt
2010).
Two focus groups one with
management, the other with frontline
practitioners ensured all main
professional disciplines involved in
progressing patients through the
hospital were represented (Linhorst
2002).
The focus groups were guided by
research questions that came out of
the literature and aimed to identify
reasons for delayed discharges and
possible interventions.
For more information, please visit us at www.ncpqsw.com or phone 01202 964765
Reducing delayed
discharges in a secure
psychiatric hospital
Author: John Paul Anastasiadis
South Essex Partnership University NHS Foundation Trust Supporting social work and health practitioners to improve
services one setting and one service provider at a time.
Service
Improvement
Projects
The improvement of services, for the people we
serve, is at the heart of professional practice. This
is why we have designed a Masters degree to
include a focus on service improvement.
The Service Improvement journey at BU is
split into two Masters degree level units:
PSIP and SIP.
PSIP stands for Preparing for your Service
Improvement Project. Successful completion of
PSIP is a pre-requisite for moving on to the SIP
unit. It allows practitioners to develop a service
improvement proposal over a period of about 5
months and is primarily about THINKING.
SIP stands for Service Improvement Project
and is primarily about DOING or implementing
the proposal in practice. This poster is based on a
SIP completed in 2014.