Compliance Not Applicable
Conditions
Interventions
Services randomised to the intervention group will go through an annual peer-review cycle set up by the managers of the forensic quality network. During this review cycle the services are asked to com
Sponsors
Royal College of Psychiatrists (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. All stand alone low secure services in England and Wales 2. Participating patients are both male and female individuals above 18 years old detained under the Mental Health Act (1983) in a stand alone low secure service
Exclusion criteria
Exclusion criteria: Low secure services are not eligible for the study if they are based on the same site of medium secure services. This is because staff who work across both sets of services may already have implemented quality improvement measures resulting from their experience of taking part in this other network, which has the potential to 'contaminate' the results.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The services? compliance with a selection of key standards of care measured with an environmental checklist. The checklist covers the following standards: 1. Whether the service has an external perimeter that meets the standards for security 2. Whether there are separate, accessible and appropriately furnished facilities for visitors 3. Whether all visitors, staff and patients access the unit via airlock 4. Whether there are any ligature points on the ward(s) 5. Whether the service has a multi-faith room accessible and appropriate for use by all patients 6. Whether the service has a seclusion room 7. Whether the service has a de-escalation room 8. Whether patients? bedrooms are designed to maintain safety 9. Whether there is a variety of recreational facilities accessible to patients 10. Whether there is a variety of occupational facilities accessible to patients The maximum total score for the environmental checklist is 100. The higher the score on this checklist the higher the compliance of the services with the key standard of care assessed All outcomes are measured at baseline and at 12 months. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Safety of the service measured by number of violent incidents and people absconding 2. Levels of patient satisfaction measured with a shorter 4-items version of the Quality of Care Questionnaire (QOCQ). The items are scored with a Likert scale ranging from '4' (very satisfied) to '0' (very unsatisfied). The higher the total score the higher the level of patient?s satisfaction 3. Patients? mental well-being measured with the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS). Each question is scored with a Likert scale ranging from '1' (none of the time) to '5' (all the time). The higher the total score the higher the level of mental well-being of the patients 4. Levels of staff burnout measured with the Maslach Burnout Inventory (MBI). The 22 items of this survey create three general subscales assessing: emotional exhaustion, depersonalization and personal accomplishment. The items are scored on a 7-points Likert scale which ranges from 0 = 'Never' to 6 = 'every day'. High scores of emotional exhaustion and depersonalization together with low scores of personal accomplishment indicate high levels of burnout 5. Costs of service provision (e.g. cost per bed) All outcomes are measured at baseline and at 12 months. | — |
Countries
United Kingdom
Outcome results
None listed