Implementing and evaluating patient-focused safety technology on adult acute mental health wards

What is known on the subject

• Mental health wards can feel unsafe. We know that patients and staff have different ideas about what makes a hospital ward safe or unsafe.
• Patients are often the first to know when the atmosphere on a ward becomes tense, but often, no one asks them for their views.
• Patients and staff are experts and should be included in discussions about how to make wards safer.

What this paper adds to existing knowledge

• We got together with some service users and staff, and made an app that helps patients to tell staff when they are not feeling safe on a mental health ward. We tried it out on six wards and we asked patients and staff what they thought.
• The app was easy to use and most people liked the look of it.
• Patients said staff did not talk with them enough and so they liked using the app. However, some staff said they could tell how patients were feeling without an app and so they did not need it. Ward managers told us that staff were often very busy and did not always have time to use the app.

What are the implications for practice

• This app could help staff know straightaway when patients do not feel safe on the ward, so that they can act quickly to calm things down.
• To make the most of the app, staff need to get used to it and bring it into ward routines.

Introduction

Safety improvement on mental health wards is of international concern. It should incorporate patient perspectives.

Aim

Implementation and evaluation of ‘WardSonar’, a digital safety-monitoring tool for adult acute mental health wards, developed with stakeholders to communicate patients' real-time safety perceptions to staff.

Method

Six acute adult mental health wards in England implemented the tool in 2022. Evaluation over 10 weeks involved qualitative interviews (34 patients, 33 staff), 39 focused ethnographic observations, and analysis of pen portraits.

Results

Implementation and evaluation of the WardSonar tool was feasible despite challenging conditions. Most patients valued the opportunity to communicate their immediate safety concerns, stating that staff had a poor understanding of them. Some staff said the WardSonar tool could help enhanced ward safety but recognised a need to incorporate its use into daily routines. Others said they did not need the tool to understand patients' safety concerns.

Discussion

Foreseeable challenges, including staff ambivalence and practical issues, appeared intensified by the post-COVID-19 context.

Implications for Practice

The WardSonar tool could improve ward safety, especially from patients' perspectives. Future implementation could support staff to use the real-time data to inform proactive safety interventions.