Improving patient safety in
mental health

October 9, 2012 4:48 pm Views: 364
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Providing safe healthcare to vulnerable populations is no easy feat.

Many patient groups seeking medical care come with complications that distinguish themselves from others and pose unique challenges to their team of providers. Perhaps nowhere is this more evident than when treating patients with mental health needs.

In addition to being at risk for the same patient safety incidents we all face when receiving care (falls, medication errors, infections, to name a few), patients with mental health needs are also at risk of other patient safety incidents not commonly found in acute care settings.

Some of these include patient safety issues surrounding seclusion and restraint use, self-harming behaviour and suicide, absconding, and reduced capacity for self-advocacy.

According to research conducted by the United Kingdom’s National Patient Safety Agency, 84 per cent of patient safety incidents reported among mental health patient populations included falls, elopement, aggression and self-harm/suicide. Further complications arise due to the fact that focus on physical harm sometimes ignores the emotional and psychological harm suffered in the wake of a patient safety incident.

Yet another set of complications arise due to the conflict between safety measures and patient autonomy. Policies enacted by the health care system to improve patient safety in mental health settings are often seen as controversial and unethical as a result of their impact on a patient’s human rights. These can include locking units and restraints, searches and confiscation of prohibited items and the use of closed circuit television systems to monitor patient activity.

All of this suggests a dire need to improve our understanding of the unique challenges facing patients with mental health needs in order to improve the outcomes of the care they receive.

Our obligation is to work within the health care system and to educate health care providers with the knowledge they require to successfully navigate the difficulties surrounding patient care in mental health and ensure the patients in their care are not only receiving safe care, but that it is being delivered in a manner that doesn’t compromise their human dignity and that is respectful and understanding of their unique needs.

In order to accomplish this, we’ve begun by leveraging the educational power of the Patient Safety Education Program (PSEP – Canada).

A program of the Canadian Patient Safety Institute, PSEP – Canada is designed to strengthen an organization’s internal capacity for education and grow quality improvement and patient safety initiatives by using a train-the-trainer model. Participants of PSEP – Canada courses, which are taught by well-respected quality and patient safety health care professionals and educators from across Canada, return to their organizations as certified PSEP – Canada trainers and are able to provide patient safety education to their colleagues.

One of the modules of the PSEP – Canada curriculum focuses exclusively on patient safety in mental health. The module currently provides an introduction to patient safety and mental health and preventing suicide and self-harm. Sections on seclusion and restraint, violence and aggressive behaviour, and absconding patients, are in development and will be released by the end of the year.

The PSEP – Canada program allows participants to go back to their organizations with a comprehensive systems level view of patient safety combined with strategies for peer to peer leverage to more effectively drive patient safety improvement including patient safety initiatives in mental health.

To learn more about patient safety in mental health and the PSEP – Canada program, please visit www.patientsafetyinstitute.ca.

Article By:

Hugh MacLeod

Hugh MacLeod is the CEO of the Canadian Patient Safety Institute.

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