Implementation and evaluation issues.

Staged or comprehensive implementation

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7 years 8 months ago #633 by Sim
I'm in Newcastle, NSW. We are in the planning stages of introducing Safewards into PICU initially as a pilot then if this goes well into the three adult acute wards and possibly outlying wards in rural NSW. I was hoping for some guidance/ experience of staged vs comprehensive implementation. We are in a privileged position that we have some external people to drive the project forward (2x clinical nurse educators and a full time PMVA trainer). I'm therefore hoping that some of the barriers re time from clinical staff/ champions for the practical steps will be easier to overcome. That being the case I'm thinking that going for full implementation following team building days and period of staff engagement would work but am open to other ideas. As an additional note, although we have some external drivers we only become involved following initial interest and motivation from staff on the ward.
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7 years 8 months ago #634 by Sim
Sorry, just been carefully reading through the implementation guide and see that it suggests 1 intervention/ week or in bundles of 2 or 3. I'd still be interested in peoples experience of this - what have been the barriers, do bundles work well etc.
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7 years 8 months ago #635 by len.bowers@kcl.ac.uk
Hi Sim,

The reality is some interventions take much longer than others, and all take time to really integrate into the everyday life of the ward. Another factors is the level of enthusiasm of the staff, which tends to differ for each of the interventions.

Len
The following user(s) said Thank You: Sim
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7 years 8 months ago #637 by newellj
Hi Sim,

In Brisbane we had staged implementation in approx 14weeks, however this was longer in our larger areas [6 months]. We began every intervention with 2-3 weeks of planning and education, then roll out commenced in the third week and usually progressed for 3 weeks.
We found it beneficial to start with clear mutual expectations [CME] as this is a collaborative intervention requiring input and consideration from all staff.
We found ourselves having to be innovative in education and sometimes educating around the intervention. For example, staff struggled a little in drafting CME as they all have different personal limits for what they tolerate and think about how things should be. So we ran a 4 hour workshop on boundaries and limits. We also ran a full day group facilitation workshop for staff who wanted to run groups, as staff reported 'lacking in confidence' in this domain, improving this resulted in better results in our mutual help meetings and resulted in staff commencing other groups.
For our know each other intervention we are planning mini staff videos, 45sec clips of staff introducing themselves, a point of info and something about their expertise, this will be set to play every morning in our communal area, as the folders do not seem to have instilled the essence of the intervention.
Having external support is essential especially in terms of planning schedules and organising the research elements but it is essential to involve and include a s many staff as possible to promote model integration.
I think safewards is a clever comprehensive tool and guide for anyone working in mental health that will help keep themselves and consumers safe and promote consumer empowerment.

Best of luck!
The following user(s) said Thank You: Sim
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7 years 7 months ago #639 by Sim
We are still planning and moving forward. I'm off to Melbourne in a couple of weeks for their Safewards forum and feedback/ evaluation so will be good to hear about their implementation approach. I'm thinking that more patience is a good thing...staged and careful implementation appears to be the way to go - I plan to draw up a tentative timetable when I return.
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