Safewards Discharge Messages Refresher Explanationinformation Role modelling Patient

Safewards Discharge Messages Refresher

Explanation/information, Role modelling, Patient education, Removal of means, Presence & presence+ Staff Modifiers Denial of request, Staff demand, Limit setting, Bad news, Ignoring Flashpoints Staff anxiety & frustration, Moral commitments, Psychological understanding, Teamwork & consistency, Technical mastery, Positive appreciation Staff Modifiers A, , IC Rules, Routine, Efficiency, Clean/tidy, Ideology, Custom & practice Internal Structure Staff Team ics s s, ne c ti blo rs g rou tive ifie ckin erna od e, Che dy, Alt ff M isitiv & Ti Sta & inqu, Clean spect t oin de, shp litu Exit Fla ecy, Soshock, r Sec ission ked m Ad CONTAINMENT ork Anxiety management, Mutual support, Moral commitments, Psychological understanding, Technical mastery rist hy , Male, g cte p ed un ara ogra. , Abusall. s, Yo Ch em nhib s, H nt & d y/disi lusion tie Pa ptomsritabiliitght, De , Ir ns Symtraits sion, I s rs , PD re oia s, Dep an Par /drug Alc Patient Modifiers al f E r Ap ame xter pe wo n Re als, Prork, Natal Stru gul io s ato ecutionnal polcture ic s, ry Fra Hospitya, Comp la lp me w olicy ints, & sis ifie od erapy al analyns ff M coth ction entio Sta. Pharmya & fun& interv rap ort the upp cho g s ts Psy ursin N or al E sic t U Re ce ilan enan ices, PIC vig t n, cho gly Main sio nts rin Ca cor, es eclu poi Dé tur ity, S ture Fea plex , Liga om ooms , C t lity ory r en ua s , Q sen nm ked rt/ iro loc omfo nv C Do y Ph Leg Flashpoints Assembly/crowding/activity Queuing/waiting/noise Staff/pt turnover/change Bullying/stealing/ prop. damage oin s; y shp tion ntit Fla rba ide e c ce/ ty Exa nden everi s e ep ity/ Ind Acu CONFLICT C Fla Ad omp shp uls m o Co mp ission ory d ints l a tre int , App eten atm de ti e en nied al ref on, D t, E , En usa Ho ue p S t x pe l a it r f f , roc efu orce , Leg Infor ess, J f M sed d m o u Co itima atio stice dif nsi cy, n g , R ier ste e i nt Comp ving, spec s po licy ensa Supp t for , Fl tor ort righ exi y a bili uto to ap ts, p ty, n Re omy eal, spe , ct ie ctiv mil in e p y th volv rs ati era em en en t su py t pp F o l r Ba a t d n sh Los ew po s o s, H in acc f rela ome ts om tio cri Arg mod nship sis, um atio or en n, t Ou ito tsid De rs, Re pe e. H nd lative en osp cy s & f Str & i am ita e s nst i l itu ly ten sors tio na sions lisa tio , Pros n, De pecti ma ve Sta nd –ve Ca s& rer ff M /re ho move lat od me i F ve if a A Vis Patient Community Patient – patient interaction Contagion & discord

Background Discharge messages provides a way of helping people connect with hope by: – Demonstrating care and concern – Attending to what people feel and are concerned about – Creating an avenue for patients to inspire and support each other (even anonymously) – Providing hopeful messages from other patients (rather than from staff) Patient engagement is fundamental to this intervention

Aims When a patient is preparing to leave, there is an opportunity for them to provide a discharge message as a form of closure for themselves and to help others on the unit. Aims: • Provide authentic encouragement and support for new patients • Provide hope and convey messages about the purpose and potential benefits of an admission • Provide a boost to self-esteem / identity on leaving the unit through making a valued contribution to the patient community

Discharge messages and the Safewards Model Staff modifier: Staff modifiers Discharge messages Originating domains: • Patient community • Patient characteristics • Originating Physical environment domains Patient modifiers: modifiers Hope, mutual help Flashpoints Conflict Containment

Role of the intervention lead • Establish the discharge message tree or noticeboard • Check the discharge message tree or noticeboard, keep it tidy and remind staff to encourage writing a message when a patient's discharge is forthcoming • Remind patients the opportunity to complete a discharge message (this could be done during a mutual help meeting). Offer support to write the message if necessary.

Discharge messages fidelity Discharge messages IS Discharge message IS NOT = ≠ • A way of passing on the messages & advice from leaving patients to arriving patients • Delivering positive messages to provide hope and encouragement to arriving patients • A way of highlighting how good the unit and staff are to visitors • Soliciting compliments from patients leaving the unit to make the staff feel good

Discharge messages adjustments CAMHS None Forensic Goodbye messages, transfer messages Older people None in some cases, impossible in others, engaging family