The Journal of Adult Protection 1 | P a g e Putting people at the centre: facilitating Making Safeguarding Personal approaches in the context of the Care Act 2014 Abstract PurposeThe purpose of this paper is to describe and discuss the pilot Making Safeguarding Personal (MSP) project that ran in three London Boroughs in England in 2014-2015. The project aimed to help local authority social work practitioners better engage with adults at risk at the beginning, middle and end of safeguarding work and to develop a more outcomes focussed approach to safeguarding. Design/methodology/approachThree adult social care teams volunteered to take part in the MSP pilot for 4 months, November 2014 -February 2015. They were closely supported through telephone conferencing, bespoke training, and individual mentoring. Evaluative data were collected from the participating teams about their work and the MSP change processes to assist in further implementation. FindingsThe findings suggested that staff felt that the open discussions with adults at risk that were encouraged by the MSP initiative enabled safeguarding to be more effective and provided a better basis of support for adults at risk. The support from the project team was appreciated. Staff reported their own increased confidence as a result of involving adults at risk in decisions about their situations and risks of harm. They also reported their increased

The Breakthrough Series Quality Improvement Collaborative (QIC) initiative is a well-developed and widely used approach, but most of what we know about it has come from healthcare settings. In this article, those leading QICs to improve care in care homes provide detailed accounts of six QICs and share their learning of applying the QIC approach in the care home sector. Overall, five care home-specific lessons were learnt: (i) plan for the resources needed to support collaborative teams with collecting, processing, and interpreting data; (ii) create encouraging and safe working environments to help collaborative team members feel valued; (iii) recruit collaborative teams, QIC leads, and facilitators who have established relationships with care homes; (iv) regularly check project ideas are aligned with team members’ job roles, responsibilities, and priorities; and (v) work flexibly and accept that planned activities may need adapting as the project progresses. These insights are targeted at teams delivering QICs in care homes. These insights demonstrate the need to consider the care home context when applying improvement tools and techniques in this setting.

In this simulation-based study, a telepresent team leader was associated with increased team workload compared to usual care. However, no differences were noted in teamwork and processes of care metrics.

Medical experiences can be frightening and traumatic for children. Ill and injured children can experience pediatric medical traumatic stresspsychological and physiological distress responses related to their medical event and subsequent medical treatment experiences-which can lead to symptoms of posttraumatic stress disorder (PTSD) and suboptimal health outcomes. Trauma-informed care provides a framework for acknowledging, addressing, and mitigating the risks of psychological trauma associated with medical treatment experiences and is congruent with the ethical principles of respect for autonomy, beneficence, nonmaleficence, and justice. Health care systems and professionals are encouraged to apply the principles of trauma-informed care to address the effects of pediatric medical traumatic stress. IntroductionFor the sick or injured child, being treated in the emergency department (ED) or admitted to the hospital can be a frightening and confusing experience that leads to subsequent psychological distress [1]. Experiencing pain, feeling helpless and out of control, and being separated from one's parents are all factors that contribute to the potentially traumatic nature of medical events. How does a physician's ethical obligation to "first, do no harm" square with the prospect of providing a therapeutically necessary procedure for a frightened child who does not understand what is being done and why? How do we understand the ethical issues involved when a medically beneficial course of treatment for a pediatric patient also has the potential to engender stress, fear, anxiety, pain, or discomfort for this child? In this brief review, we first describe two concepts that are key to understanding and addressing the psychological distress that can affect ill and injured children: pediatric medical traumatic stress and trauma-informed pediatric care. We then discuss four core principles of medical ethics (respect for autonomy, beneficence, nonmaleficence, and justice [2]) and explain how the application of these principles underscores the need for trauma-informed care.