Assessing early feasibility of a novel innovation to increase consumer partnership capability within an Australian health innovation organisation using a mixed-method approach.

OBJECTIVE: Engagement-capable health organisations recognise that consumer engagement (also known as patient engagement, consumer engagement, patient and public involvement) must occur at every level of the organisation if it is to be meaningful and genuine. Despite this aspiration, health organisations struggle to adopt, implement, and embody consumer engagement capability in a way that has yielded impact. The Partner Ring (PR) is an embedded model for building staff capability for consumer partnerships. It is hosted by an employed Patient Partner. PR was implemented at the Agency for Clinical Innovation in New South Wales, Australia. The aim of this study was to assess the feasibility (acceptability, demand and practicality) of this innovation to increase consumer engagement capability. DESIGN: One-group post-intervention mixed methods approach to assess feasibility. PARTICIPANTS: ACI staff engaged in the PR (n=40 of 89 members). DATA COLLECTION AND ANALYSIS: Qualitative data was collected through an artificial intelligence (AI)-driven interactive interview, with 40 responses received between 29 June and 12 July 2023. A framework analysis and Generative AI causal mapping were conducted to identify and visualise causal claims within the texts. Cost and session attendance collected from the same point in time supplemented the analysis. FINDINGS: Findings were categorised by the following feasibility constructs: acceptability, demand and practicality. Almost all the respondents indicated their intent to continue using the PR and outlined personal benefits and professional benefits. For example, (n=23, 57%) reacted positively to the psychological safety of the PR, and professionally people identified attendance increased their knowledge and skills (n=23, 57%). CONCLUSION: The PR is feasible and likely to be an acceptable innovation for building staff capability and consumer engagement skills across a large health system or organisation. It could be adopted or adapted by other jurisdictions.

Staff experience, knowledge and attitudes regarding the management of adolescent patients in adult mental health units.

OBJECTIVE: Inpatient psychiatric care of adolescents should, where possible, be provided in specialized units. However, admission of adolescent patients to adult mental health units does occur. There is a paucity of data about this practice. This study collates information about the experience, attitudes and knowledge of clinical staff regarding the care of adolescent patients in adult psychiatry units within Northern Sydney Central Coast Area Health Service (NSCCHS). METHOD: A survey was emailed to all clinical staff with employer accessible email addresses in NSCCHS. RESULTS: The response rate was 29% (n = 108). The majority of respondents believed their wards were "not at all" (30.7%) or "only a little" (57.4%) equipped to care for adolescent patients. The majority felt "moderately" (39.6%) or "very" (16.8%) confident to care for these patients; however, a significant proportion (43.2%) lacked confidence. There was no significant difference across the responses of psychiatrists, psychiatry registrars and nursing staff to these questions. The majority felt the objectives of these admissions were met "only a little" (47.4%) or "not at all" (16.5%). Many concerns regarding the admission of adolescents to adult wards were reported. CONCLUSIONS: Generally, staff were not in favour of admitting adolescent patients to adult mental health units apart from in exceptional circumstances. Staff harboured concerns about several aspects of care for adolescents in adult wards.

Enabling clinicians to become the quality leaders in a mental health service.

OBJECTIVE: To show how clinicians can become the leaders of 'quality' in a mental health services, using the example of developments within Northern Sydney Health (NSH) Area Mental Health Services (AMHS). METHOD: In the absence of an existing integrated area quality programme, NSH AMHS implemented a quality improvement programme whereby staff at the coalface would become the leaders in 'quality' guided and supported by the newly established Quality Unit. This innovative approach is consistent with evidence that suggests that clinicians need to 'own' quality improvement initiatives and embed them into everyday practice, rather than see them as the role of a designated 'quality' person/s. RESULTS: Within 12 months the service trained over 100 clinicians in Clinical Practice Improvement (CPI) methodology and currently has over 20 CPI projects with an identified measurable outcome. As well, it has provided over 200 staff with in-services on quality improvement approaches and trained 45 staff in root cause analysis. Training of eight clinicians in the use of the Minitab statistical package has allowed data analysis and charting to identify opportunities for improvement. CONCLUSION: The handing of 'quality' back to clinicians of the AMHS has provided a framework for improved outcomes for patients and carers. This approach to service improvement is transferable to other mental health services.