Supporting carers to improve patient safety and maintain their well‐being in transitions from mental health hospitals to the community: A prioritisation nominal group technique

Author:

McMullen Sarah1,Panagioti Maria23ORCID,Planner Claire2,Giles Sally2ORCID,Angelakis Ioannis4,Keers Richard N.567,Robinson Catherine8,Fu Yu9,Johnson Judith10,Tyler Natasha23ORCID

Affiliation:

1. Centre for Primary Care and Health Services Research, Division of Population Health, Health Services Research and Primary Care, Faculty of Biology, Medicine and Health The University of Manchester Manchester UK

2. NIHR Greater Manchester Patient Safety Translational Research Centre The University of Manchester Manchester UK

3. NIHR School for Primary Care Research The University of Manchester Manchester UK

4. Department of Primary Care and Mental Health The University of Liverpool Liverpool UK

5. Division of Pharmacy and Optometry, Centre for Pharmacoepidemiology and Drug Safety The University of Manchester Manchester UK

6. NIHR Greater Manchester Patient Safety Translational Research Centre Manchester Academic Health Science Network Manchester UK

7. Suicide, Risk and Safety Research Unit Greater Manchester Mental Health NHS Foundation Trust Manchester UK

8. Social Care and Society, School of Health Sciences The University of Manchester Manchester UK

9. Population Health Sciences Institute Newcastle University Newcastle UK

10. School of Psychology University of Leeds Leeds UK

Abstract

AbstractIntroductionCarers of people with mental illness may face distinct challenges, including navigating fragmented health and social services during discharge from mental health hospitals. Currently, limited examples of interventions that support carers of people with mental illness in improving patient safety during transitions of care exist. We aimed to identify problems and solutions to inform future carer‐led discharge interventions, which is imperative for ensuring patient safety and the well‐being of carers.MethodsThe nominal group technique was used which combines both qualitative and quantitative data collection methods in four distinct phases: (1) problem identification, (2) solution generation, (3) decision making and (4) prioritisation. The aim was to combine expertise from different stakeholder groups (patients, carers and academics with expertise in primary/secondary care, social care or public health) to identify problems and generate solutions.ResultsTwenty‐eight participants generated potential solutions that were grouped into four themes. The most acceptable solution for each was as follows: (1) ‘Carer Involvement and Improving Carer Experience’ a dedicated family liaison worker, (2) ‘Patient Wellness and Education’ adapting and implementing existing approaches to help implement the patient care plan, (3) ‘Carer Wellness and Education’ peer/social support interventions for carers and (4) ‘Policy and System Improvements’ understanding the co‐ordination of care.ConclusionThe stakeholder group concurred that the transition from mental health hospitals to the community is a distressing period, where patients and carers are particularly vulnerable to safety and well‐being risks. We identified numerous feasible/acceptable solutions to enable carers to improve patient safety and maintain their own mental wellbeing.Patient and Public ContributionPatient and public contributors were represented in the workshop and the focus of the workshop was to identify the problems they faced and co‐design potential solutions. Patient and public contributors were involved in the funding application and study design.

Funder

NIHR School for Primary Care Research

Publisher

Wiley

Subject

Public Health, Environmental and Occupational Health

Reference31 articles.

1. Office for National Statistics.Unpaid Care by Age Sex and Deprivation England and Wales: Census 2021. Office for National Statistics; 2023.

2. Carers Week.Make Caring Visible Valued and Supported: Carers Week 2022 Report. Carers Week; 2022.

3. The Carers Trust.The triangle of care carers included: a guide to best practice in mental health care. 2013. Accessed June 14 2023.https://www.crisiscareconcordat.org.uk/inspiration/the-carers-trust-the-triangle-of-care-carers-included-a-guide-to-best-practice-in-mental-health-care/

4. “I’m Trying to Stop Things Before They Happen”: Carers’ Contributions to Patient Safety in Hospitals

5. Hidden caring, hidden carers? Exploring the experience of carers for people with long‐term conditions

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