1.1.3 An evaluation of the impact of the move to a new mental health inpatient facility on staff and patient outcomes (301)

Fiona Nolan, Nursing Research Fellow, Centre for Outcomes Research and Effectiveness (CORE), Sub Dept Clinical Health Psychology, UCL, London, United Kingdom Co authors: Stephen Pilling & Sonia Johnson

Abstract:

Background & context:

Despite increased interest in the development of community care over the past 30 years, inpatient services continues to receive over 50% of the mental health funding in the UK. Concerns about the standard of inpatient care have been expressed, particularly over the past decade. This has led to initiatives to improve services, but there is little evidence as to their effectiveness.

Aim:

To investigate whether the move to a new inpatient premises in central London was successful in terms of improving staff and patient outcomes.

Methods:

A natural ‘before and after’ design was used, and all wards which were affected by the move were included. The staff experience was investigated using the Ward Atmosphere Scale (WAS) and the Maslach Burnout Inventory. We investigated that of patients using the WAS, the Client Satisfaction Questionnaire (CSQ) and the ‘Your treatment and Care’ questionnaire. 158 patients were included in the first stage, and 145 in the second, with response rates of 80% and 75% respectively. Staff figures were 182 (RR= 80%), and 197 (RR= 74%) respectively.

Analysis:

Data were analysed using SSPS version 11.5.

Findings:

Results for patients showed statistically significant changes in CSQ scores, and in almost all items in the ‘Your Treatment and Care’ measure. Levels of staff burnout appeared unchanged, expect in rehabilitation wards. Among the WAS findings were higher levels of staff control as perceived by patients, and lower levels of anger and aggression. Service level data on untoward incidents demonstrated a significant improvement in the year following the move, but this was not maintained over longer periods.

Conclusions:

The study sample demonstrated improved patient satisfaction following the move, lower ward incident rates, and equivocal levels of staff burnout.

Biography:

I have worked in a variety of mental health inpatient and community services in the London area since 1987. I am currently employed as a research fellow at University College London, and as the nursing research lead for Camden and Islington Mental Health and Social Care Trust, where I also manage a crisis resolution team. My research interests include evaluating mental health services, investigating new ways of working, staff morale and practice development. I am currently completing a PhD at UCL, supervised by Professor Paul Bebbington, on the effectiveness of crisis resolution services and their impact on patient satisfaction with treatment.