AimsTo ensure that patients who are high intensity users of acute mental health services (136 suite, Liaison, and inpatient admissions) have a ‘safety plan’ in place .This should contain person centred and specific recommendations to avert crisis and guide acute clinicians in managing care in a crisis situation.MethodsAudit of electronic health care records of top 10 patients who most frequent attend each of s136 suite, LPS and inpatient wards (26 in total) in the period 05/2021 to 04/2022.Process mappingDriver diagramCoproduction via patient engagement teamFocus group-across care groups and lived experienceResults-Audit of 26 identified HIU – whilst most (>80%) had a ‘safety plan’ in place, these lacked sufficient detail to avert ‘crisis’ and guide appropriate treatment should the situation escalate. The most frequent diagnosis was EUPD (77%). Most (93%) were open to CPA pathway. •Process mapping – visual representation of crisis planning process within CPA process.•Driver Diagram – primary and secondary drivers leading to change ideas of: additional ‘HIU response plan’ template; best practice example to guide care coordinators; process of flagging up HIU to community mental health services.•Focus group – themes included the importance of : joint working across care groups’ transparency with patients regarding professional opinion; consistency of interventions during a ‘crisis’; and coproduction of safety plans.•HIU response plans are incorporated into the safety plans of 20/26 HIUs.•PDSA process ongoing – quality assurance and clinical effectiveness of changes to be reviewed. Further change ideas sought through QI process.ConclusionHigh intensity users who often present in ‘crisis’ to acute mental health services, have unmet needs.This cohort require an additional framework to meet their needs.When patients experience a mental health ‘crisis’, a consistent and clear treatment response is experienced as helpful.Safety/crisis planning is thus an important aspect of meeting needs.HIU response plans’ can be incorporated into a patients ‘safety plan’ to ensure that individualised and specific guidance is available.Best practice example of ‘HIU response plans’ can empower community mental health colleagues to co-produce such plans.
The Royal Dutch Shell Group's 1997 policy on Health, Safety and Environment included a commitment to sustainable development. Since then there has been a struggle to grasp the concept and to identify areas in which our inherently unsustainable business can make its mark. Shell has interpreted the Brundtland Commission's definition of sustainable development in terms of three fundamental pillars: economic growth, environmental conservation and societal gain. This paper follows ‘Shell in Egypt’s journey from making the commitment, through a phase of ad hoc contributions, and to a stage where sustainability is managed as any other business item. The ultimate aim of the paper is to demonstrate how sustainability will be introduced into the corporate business plan, as a measurable item against which we can measure our performance, be audited and benchmark. Also to offer ideas as to how this can be achieved in other companies. Introduction A sustainable development is defined by the Brundtland commission (Earth Summit, 1992) as a development that "meets the needs of the present without jeopardizing the ability of future generations to meet their own needs". The Royal Dutch / Shell Group of companies made a commitment in 1997 to try to meet both present and future needs by conducting its business in a way that is inherently sustainable. We believe that the needs of the present and the future can best be met by serving three main focus areas: capacity building, economic growth and environmental conservation. As such, there will be reference to the "three pillars" of sustainability in this paper: society, economy and environment. One might ask how did this philosophy evolve? It has taken us about two decades to fully integrate environmental issues into decision making and business planning. Today industry and the general public has come to expect environmental conservation of us - but not as a minimum; the minimum now includes community aspects as well. It is widely agreed that industry must engage the community that is directly or indirectly affected by a business. We must behave as good corporate citizens, participating, teaching and assisting the community wherever we can. Unfortunately this does not take into account that business must make money. Sustainable development is different. It demands both environmental conservation and capacity building, while still allowing a company to run its business profitably, and - in the longer run - add to the wealth of the hosting country's economy. In fact companies that behave sustainably have been shown to be better performers. The Dow Jones industrial average now features a new index, measuring sustainability (www.indexes.dowjones.com). The index measures companies on a series of sustainability indicators and ranks their performance on the stock market. It demonstrates that companies outperform the competition by almost 5% for 1% extra risk taken to achieve sustainability (referred to as the compatibility of returns). Moreover, there is a trend among private and institutional investors towards "ethical investment' meaning favouring companies that pay due attention to the community and environment. Although the criteria used by the Dow Jones index to measure sustainability are not quite those used by the Shell Group, the principle still stands. That principle is that sustainability is becoming an investible concept, and one who's practice is being broadly adopted to gain a corporate advantage.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.