Planning and implementation

So you want to implement Safewards interventions on your ward or in your unit or hospital. What do you have to do? What should you think about first?

Of course everywhere is different, so we can’t give you a precise list of things to do, but do make sure you cover everything indicated below. For the most part we also recommend you do them in the order we indicate below.

1. Invest in early planning

Familiarise yourself with the Safewards interventions. Download and read all the documentation and read it carefully. View all the videos. Make sure you know exactly what is involved. Don’t rush off enthusiastically without realising what you are getting into.

2. Consult your colleagues

Propose to your colleagues (managers, peers and front line workers) that you implement Safewards. You can find some useful powerpoint pptslides here. Try to make sure you get as many people behind you as possible. If you need the permission of others, make sure that you get it at this stage. Even if you don’t need permission, it is a good idea to consult everyone who might have an interest, including all the disciplines and professions that work on the ward(s) concerned.

3. Secure the financial resources you need

Safewards is not expensive, but some money is required for equipment and printing. It is not really possible to go ahead without this, so you need to get access to a budget and someone with the authority to spend from that budget. We estimate that you will need about £600 per ward.

4a Start more concrete planning

Set a loose date for when you will start implementing Safewards. We recommend that this is at least three months in the future at this stage. The ward manager(s) and their staff need to decide how they will implement each of the interventions on their wards, and to do that they need to look at the intervention instructions and view the video training packages. The hospital/ward needs to determine exactly what equipment will go in the Calm Down Box, where they will put the Clear Mutual Expectations posters, etc. Go through each of the ten interventions with a practical eye together with the ward staff and think about what needs to be decided in advance. Decide how you will get material printed and from where. Determine how you will laminate the personal information going in the Know Each Other folder. If you decide to have a ward champion for each intervention, agree with the wards teams who will champion which intervention.

4b. Secure the equipment you need

Order the equipment you need as soon as you can. Mostly this needs to be acquired in advance, for example the contents of the Calm Down Box, the folder for Know Each Other information, etc.

4c. Select your desired evaluation methodology

It is not mandatory to audit or evaluate your Safewards interventions. We know they work because of the results of the Safewards trial. The Safewards trial used the same scientific methods that have shown the efficacy of psychotropic drugs, antibiotics, routine surgical techniques, etc. We don’t collect new evaluation and audit data every time we use Clozapine, for example.

If you do decide to do a local evaluation, consult the various strategies here. Depending on the strategy you select, there may be local approval processes for ethics, and you may need to give some thought to data entry, who will analyse that data, and who will write up any report. You may be able to commission some of this work from us, and if you wish to do so, please contact us as soon as possible. Going ahead with Safewards implementation without deciding on an evaluation strategy may make some evaluation methods impossible. If you do decide to conduct a local evaluation independently, we would be very keen to see you publish the results, whatever they were.

5. Review your dates

When you can answer yes to all the questions on xlsxthis list , then set a new start date, which can be in the next few weeks. At this point fix a timetable for which intervention will start when. You could start a new intervention each week, or start them in bundles of two or three. We do not recommend trying to start all of them all at once. Make sure the ward concerned, all the staff, and especially the champions know what is starting when. It might be a good idea to display this timetable in the ward concerned.

6a. Implement the interventions according to your timetable

You may want to have regular review meetings at which ward staff or ward managers can report on their progress, or identify any delays or blockages that can be removed with assistance from others.

6b. Connect to the Safewards web site and to discussion forum

As you go forward with implementation, make sure your front line staff make connections with others via the discussion forum on this web site. They can get advice from others there on useful adaptations and on overcoming common hurdles.

6c. Implement your evaluation strategy

Note that for some methods you should start collecting evaluation data before you start implementing the Safewards interventions.

We wish you every success with your project management for Safewards. If you wish to discuss this and share expertise with others, there is a specific thread on the discussion forum about implementation