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A pathway to a safer service

A pathway to a safer service. Positive and proactive use of technology in clinical settings Jim Tighe & Darren Shurmer – West London NHS Trust. Background. Broadmoor has been using body-worn cameras since 2014 which brought about these positive changes:

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A pathway to a safer service

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  1. A pathway to a safer service Positive and proactive use of technology in clinical settings Jim Tighe & Darren Shurmer – West London NHS Trust

  2. Background • Broadmoor has been using body-worn cameras since 2014 which brought about these positive changes: • Decrease in violence/aggression • Decrease in reported incidents • Decrease in time for outcomes of safeguarding investigations • Increased staff confidence

  3. Background (cont’d) • Other positives: • Tested during joint operation with MET Police (Operation Duopoly) • Number of assaults against staff were being recorded • Challenge faced: • Staff to actually use the cameras

  4. Scope • Objectives for the pilot: • Working together to keep staff and service users safe • Working with service users as part of the pilot • Accurate and robust evidence for complaint and incident investigations • 50 cameras used across seven clinical areas • De-escalating violence • Modifying behaviour • Facilitate risk assessments and management of individual patients • Learning lessons • Provide a useful tool for staff training

  5. Case study 1 • Male Admission Ward Response team called with an action plan for seclusion of an aggressive heavily built male service user. Ward Manager intervened explained he was going to use the body-worn camera to record the situation. The service user responded initially with verbal abuse but started to de-escalate and work with the Ward Manager, to get to a situation where they sat and spoke. Result: Avoided seclusion, managed to get point across, no one injured and no need for physical interventions.

  6. Case study 2 • Psychiatric Intensive Care Unit Service user returning from acute care was carrying a number of risk items. He was aggressive and required teamwork intervention, where the items were safely removed but he remained agitated in seclusion. He wanting to be present while items were logged and recorded. Staff asked if he was happy for the items to be recorded using body-worn camera. Result: Service user relaxed and appreciated the staff using the camera to record the items being logged.

  7. Case study 3 • Women’s Enhanced Medium Secure Unit A high risk female service user in long term seclusion on the first floor needed to be relocated to the ground floor. This was the first use of mechanical restraints. The service user was informed that body-worn cameras would be used throughout the relocation. She requested a fixed body worn camera to the wall since it made her feel safe. Result: Service user was more cooperative knowing body-worn cameras were in use which also included recording staff. The recording enabled a comprehensive debrief and lessons learned.

  8. Challenges • IT • Need to be involved early, we involved them late • Teething problems with IT compatibility • Issues with uploading and with iCloud • Unplanned software upgrade • Research & Development • Evaluation or Research • Staff • Anxiety and remembering to turn camera on • Limited resources to allow for training • Identifying Champions early for each area.

  9. Positives so far • Service users involvement • Cameras accepted quickly in all clinical areas, particularly with service users • Clinical staff found creative ways to use the cameras in their areas • De-escalation has been seen • Increased transparency and accountability of staff

  10. Key findings • Overall 21% reduction in Verbal abuse 22% increase in violence, 6% increase in restraint and 71.5% reduction in Rapid Tranq with restraint • Women’s Forensic Service 47% reduction in Verbal Abuse from 51 to 27 incidents • Acute admission wards 100% change in highest level of seriousness - Rapid Tranq with restraint from 10 to 0

  11. To the future • Pilot completed end of 2018 • Evaluation of the pilot with service users • Cost/benefit analysis for business case to roll out cameras • Incorporate training into Trust induction and PMVA training • All planned interventions to be recorded on body-worn camera • Training video to be developed • Use in Serious Incident reviews • Supports clinical reviews

  12. Questions?

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