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Risk Assessment
and Safety Planning
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Agenda
11.15 - 11.20 Introduction – Arturo Langa
11.20 - 11.35 Two hours risk assessment experience – Paddy
Philpott and Audrey Proctor
11.35 - 11.50 Observations Guidance Review – Anna Wimberley
and Jamie Malcolm
11.50 - 12.00 Questions and Answers – All presenters
12.00 - 12.15 Workstream essentials
12.15 - 12.30 Whole group discussion
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Two hours risk
assessment
experience
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Risk Assessment – Dr Gray’s Hospital, Ward 4
• Situation
 Improve Risk Assessment Recording
 Look at Driver Diagram
 Focus on Secondary Drivers
 To complete risk assessment document within 2 hours of admission.
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Risk Assessment – Dr Gray’s Hospital, Ward 4
• Background
Ward 4 is a 20 bedded acute admission stand alone unit based within the
grounds of the general hospital named Dr Gray’s Hospital
 Pilot Site
 Driver Diagram – Risk Assessment and Safety Planning Driver
Diagram
 To complete risk assessment document within 2 hours of
admission.
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Risk Assessment - Dr Gray’s Hospital, Ward 4
• Assessment
 PDSA 1 was completed. (Attachment)
 Recording tool
 Initially a baseline was taken and current trends were
recorded
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Risk Assessment – Dr Gray’s Hospital, Ward 4
• Assessments
• Information Gathering
• Information shared
• Culture
• Awareness
• Accountability/Support
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Risk Assessment – Dr Gray’s Hospital, Ward 4
• Recommendations
 Small Steps / Achievable aim 95% completed
 Engage with staff and get understanding (Process)
 Share Information – Data
 Documentation Review
 Don't make assumption
 Dummy Folder
 Conclusion (Staffing/Training/Skill Mix/Situations)
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Risk Assessment – Dr Gray’s Hospital, Ward 4
• What Now?





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Culture Established
Audits continue but reduced
Continue Education/Awareness/Develop
Continue Awareness
Continuous learning
Risk Assessment – Dr Gray’s Hospital, Ward 4
Thank you
Any Questions?
Audrey Proctor
Senior Charge Nurse
Sandra Macgillivray
Deputy Charge Nurse
Ward 4
Ward 4
Dr Grays
Elgin
Dr Grays
Elgin
Tel no: 01343 567632
Email: audrey.proctor@nhs.net sandra.macgillivray@nhs.net
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Paddy Philpott
Patient Safety Coordinator –
Mental Health
Fyvie Ward
Royal Cornhill Hospital
Aberdeen
Tel No: 01224- 557939
p.philpott@nhs.net
Review of Good Practice Statement
Engaging People, Observation of People with Acute
Mental Health Problems
Jamie Malcolm & Anna Wimberley
CHANGES AND DEVELOPMENTS
• Legislation and policy changes that reflect
changing philosophies of care – principle based
• Greater emphasis on risk management in care
planning, and observation as a tool in overall
care and risk management
• Greater emphasis on involvement of
families/carers
• Environmental awareness – new purpose built
facilities
• Divergence, in some services, from the original
guidance and the use of ‘intermittent’ observation
• Developments in observation practice - upskilling
• Lessons learnt from reviews of the suicides of
inpatients since 2008 that have been reported to
SRLS and NCISH, and Mental Welfare
Commission review of observation
• Use in other clinical settings
WHERE HAVE WE GOT TO?
• First draft – principles
• Improvement framework to:
– improve policies
– improve practice
REVISION PROCESS
• Review Group
• Nurse Advisory Group
• Reference Group
• Consultation: 15 June – 31 July 2015
• National Mental Health Nursing
Conference 1 April 2015
REVISION PROCESS
• Other events/consultation opportunities?
• Publication November 2015
• Implementation and improvement support?
DISCUSSION QUESTIONS
1. What are the challenges to therapeutic
observation practice in your clinical area?
2. What improvement and implementation
support might your team need to improve
practice?
CONTACTS
The SRLS Project Team
• hcis.SuicideReviewTeam@nhs.net
• Pamela Campbell, Project Officer
• Jamie Malcolm, Mental Healthcare Advisor
• Vicky Rigley, Suicide Reporting Officer
• Claire Scrim, Project Officer
• Anna Wimberley, Programme Manager
Website
http://www.knowledge.scot.nhs.uk/suicidereviews.aspx
Questions and Answers
Arturo Langa
Paddy Philpott
Audrey Proctor
Anna Wimberley
Jamie Malcolm
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Risk Assessment and Safety Planning
Essentials
• Training and refresher training
• Risk assessment timing and review – 2 hours on admission, 72
hour review
• Live risk assessment – linked to goal setting
• Discharge
• Inclusion of sexual, physical, social and psychological risk
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Workstream essentials – questions/issues
•
•
•
•
Are they correct?
If not, what should they be?
What are we already doing?
What change packages, bundles, interventions should be developed and
tested to deliver them?
Lunch – available outside Strathallan Foyer and opposite
Stuart Lounge
Storyboard viewing – Strathallan
Drop in data surgery - Glenallan