NZ Guidelines Group Self-harm and Suicide Prevention Collaborative: Progress in Implementing Change and Whakawhanaungatanga
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Silke Kuehl and Dr Nicole Coupe. SPINZ Symposium Presentation, Dunedin, 29 November 2006. http://www.spinz.org.nz
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NZ Guidelines Group Self-harm and Suicide Prevention Collaborative: Progress in Implementing Change and Whakawhanaungatanga
- 1. Collaboratives – making best practice happen Silke Kuehl Emergency Nurse Advisor Self-harm and Suicide Prevention Collaborative - Whakawhanaungatanga NZGG – Self-harm and Suicide Prevention Collaborative
- 2. Outline • The collaborative − best practice implementation approach • Kiwi approach − whakawhanaungatanga • The benefits & early results − for consumers & clinicians NZGG – Self-harm and Suicide Prevention Collaborative
- 3. Our collaborative • Best practice – evidence-based guideline • Best people – team with right experience and knowledge • Best process – results focused supported collaborative NZGG – Self-harm and Suicide Prevention Collaborative
- 4. Self-harm and suicide prevention collaborative • Implementing guideline • Mental health, Emergency Departments, Māori health • Consumer focus • Families focus • 12 months • 10 DHBs NZGG – Self-harm and Suicide Prevention Collaborative
- 5. Participating DHBs Northland Waitemata Counties Manakau Waikato Lakes Taranaki Midcentral Hutt Valley West Coast Southland NZGG – Self-harm and Suicide Prevention Collaborative
- 6. We are using a best practice implementation process • Support from leaders and influencers • Team approach working across services • Use key tools - process mapping, PDSA • Encourage learning from others – latest research, other DHBs • Rapid feedback on impact of change – 4 targets • Ongoing support and guidance - NZGG NZGG – Self-harm and Suicide Prevention Collaborative
- 7. Consumer pathway Community ED, Mental & Mäori Discharge Care Health Services Destination Presentation Assessment Management • Map client pathway at each of these phases of care • Identify a typical problem at each point of the process • Find examples of best practice • Identify measures to monitor improved processes • Test the changes National Institute of Clinical Studies © 2005 NZGG – Self-harm and Suicide Prevention Collaborative
- 8. NZ Flavour Whakawhanaungatanga – what we do and the way we do it… • Connected like kin or whänau • Shared responsibility for one another • Common understanding • Cheerful cooperation • Corporate responsibility (Russell Bishop, Kathy Irwin and Louise Ihimaera) NZGG – Self-harm and Suicide Prevention Collaborative
- 9. NZGG – Self-harm and Suicide Prevention Collaborative
- 10. Benefits of a Collaborative • The collaborative process can achieve rapid change • Clinician driven process means that it is implemented using an evidence-base in a way that works for clinicians in their local situation • Implementing evidence-based proven methodology that can be used again & again NZGG – Self-harm and Suicide Prevention Collaborative
- 11. Benefits for Consumers • Improved responsiveness • Better referral and coordination between emergency and mental health services • Improved access to services • Improved follow up • Culturally appropriate services • Family/whänau and friends in the picture NZGG – Self-harm and Suicide Prevention Collaborative
- 12. Benefits for DHBs • Opportunity to participate in national quality improvement project • Transferable skills • Cost effective • Professional development of staff • Manage service risk • Service improvement for consumers NZGG – Self-harm and Suicide Prevention Collaborative
- 13. Early Results • Better understanding of consumer journey • Changing attitudes in some EDs • Better relationships between Māori health, mental health and ED • Better idea of the number of people presenting with self-harm and suicide ideation NZGG – Self-harm and Suicide Prevention Collaborative
- 14. More collaboration • Collaborative methodology being evaluated in NZ • Opportunity to build on skills for other service areas • Contact NZGG for more information astewart@nzgg.org.nz NZGG – Self-harm and Suicide Prevention Collaborative
Notas do Editor
- Kia Ora. Thank you for invite. Emma Sutich. My name… My background: ED, Mental Health My experience: substandard delivery of care – lack of collaboration.
- 1. Published 2003. Good feedback. 2. Sponsors – team consists of project coordinator, MH, Maori MH, ED (Dr, nurse), consumer, family (catt, cmht, adolescent, cbt) 3. 4 targets, monthly documentation of targets, teleconferences
- 1. Evidence-based, recommendations: risk factors, therapeutic alliance, whanau, triage, assessment/referral to MH, intoxicated people, discharge, follow-up. NICS.
- Show maps.
- CEO, clinical and nursing leaders, psychiatrists, charge nurses, - enthusiasm, commitment. Problems: people leaving, not committed, time pressures, MH, Maori Mental Health, ED. Challenges: Different ED’s, hard for ED at times to understand MH and vice verca. Different agendas. Process mapping: consumer journeys, challenge for services to accept what actually happens, PDSA’s: permanent change implemented, eg assessment tool. Website: research, teleconferences, encourage use website discussion board. Eg cultural assessment – waikato Target 1: 90% access within 1 hr begin process of assessment, 2: 100% documented assessment: assessment of psychosocial stressors, cultural assessment, screen for mental illness, subsequent risk assessment within 72 hrs. Target 3: Written discharge plan given to client and whanau and sent to others involved in their care. Target 4a: 90% have follow-up appt within 48 hrs of discharge. Target 4b: 90% of people not attending appt contacted within 48 hrs of not attending. Contact person at NZGG, visits, telephone, get expert involved, eg Maori, MH, ED.
- Colette talk.