Clinical Governance in Mental Health
Clinical Risk Management | NSW Health Patient Survey Analysis | Implementation of Tracking Tragedy Recommendations | Liaison with Official Visitors Program | Mental Health Legislative Framework | Sexual Safety in NSW Mental Health Services Project | Physical Health Care of Mental Health Consumers Initiative | Suicide Prevention | Electro Convulsive Therapy (ECT) Standards ProjectClinical Risk Management
Clinical Risk Management is an ongoing and core component of work undertaken within MHDAO. It involves on-going monitoring of clinical risk through review and assessment of mental health related clinical incidents and Root Cause Analysis reports. This is facilitated by the Clinical Incident Review Committee, which is responsible for reviewing clinical incidents that occur within the mental health setting. The committee provides a collaborative and structured approach at a statewide level to the analysis of clinical incident reports.
NSW Health Patient Survey Analysis
Improvement in safety and quality in public mental health services is dependant upon input from those who use these services. Accordingly, part of MHDAO's work focuses on analysis of the data from the NSW Health Patient Survey. This survey has been developed to gain information from patients and carers across NSW about their experiences with health care services. Two mental health categories will be included in the NSW Health patient survey from 2010 onwards.
Implementation of Tracking Tragedy Recommendations
The Implementation of Tracking Tragedy Recommendations involves developing formal responses on behalf of the NSW Government to the Tracking Tragedy reports of the NSW Mental Health Sentinel Events Review Committee (SERC) and looking at how to address the recommendations within the reports. SERC is a Ministerial Advisory Committee that provides an independent review of deaths in which consumers of public mental health services were involved as suicide victims or as suspected perpetrators of homicide. Its Tracking Tragedy reports identify systemic problems and provide recommendations for improving the safety and quality of service delivery.
The NSW Government responses to these reports document what is already in place that may address the recommendations, and identify any gaps that require further work to support implementation. This work requires initiating and managing projects to address recommendations, or negotiating with other teams to undertake this, and reporting on progress to the Mental Health Priority Taskforce.
Liaison with Official Visitors Program
MHDAO provides liaison with the Official Visitors program including development and implementation of policy resulting from the programs activity as it relates to quality and safety within the mental health service system.
Official Visitors are appointed by the NSW Minister for Health to visit people in mental health inpatient facilities in NSW and are available to assist consumers on community treatment orders. They aim to safeguard standards of treatment and care, and advocate for the rights and dignity of people being treated under the NSW Mental Health Act 2007. They make regular visits to all inpatient psychiatric facilities across NSW, talk to patients, inspect records and registers, and report on the standard of facilities and services.
Mental Health Legislative Framework
A number of important pieces of mental health legislation have been reviewed and revised resulting in new or amended Acts, such as the new Mental Health Act 2007 and the amended Mental Health (Forensic Provisions) Act 1990.
A communication and training strategy was developed and commenced in 2007 to ensure mental health staff and clinicians, as well as consumers and carers, are aware of the changes and their impact. The strategy involved MHDAO working with the NSW Institute of Psychiatry to develop and deliver training for key health staff across the State throughout 2008 on the new Mental Health Act 2007 as well as information for stakeholders. Further training and information materials on mental health legislation will be provided to health staff by the Institute during 2009-2010.
Information for stakeholders was developed in 2009 around the changes to the Mental Health (Forensic Provisions) Act 1990 and the Mental Health Act Guidebook is also being updated to take account of the new provisions for this Act.
Sexual Safety in NSW Mental Health Services Project
The Sexual Safety in NSW Mental Health Services Project has been initiated to improve the safety of consumers in a mental health setting, including community and rehabilitation environments. The project involves the review and revision of the current Guidelines for the Promotion of Sexual Safety in NSW Mental Health Services, development of a Policy Directive to provide clear direction about responsibilities to mental health staff, development of resources to promote the importance of sexual safety to key stakeholders and the alignment of training provided by the Education Centre Against Violence to the new Guidelines.
Physical Health Care of Mental Health Consumers Initiative
The Physical Health Care of Mental Health Consumers Initiative has seen the development and release of a Policy Directive and Guidelines for mental health service staff to provide clear direction regarding their responsibility to ensure mental health consumers receive both physical as well as mental health care. Resources are also available to promote the intent and principles of the documents. Further plans include the provision of state-wide training for service staff on key aspects of the new documents and the development of further resources for services as well as other consumer/carer population groups.
Suicide Prevention
MHDAO is looking at ways to support NSW Area Health staff to enhance their capacity to detect, assess and effectively manage people with possible suicidal behaviour and to encourage system performance improvements to promote patient safety and quality of care. This work currently involves the review and revision of the NSW Health Policy Directive, Management of Patients with Possible Suicidal Behaviour. The framework for Suicide Risk Assessment and Management for NSW Health Staff and Guidelines is also being reviewed, which will look at both the roll out of the Guidelines as well as the uptake of the training provided through the electronic training package.
Electro Convulsive Therapy (ECT) Standards Project
The ECT Working Group, a Sub-Committee of the Mental Health Clinical Advisory Council, was established in 2008 to review the current practice of ECT in the NSW public health system and develop standards that are intended to provide staff with a clear and comprehensive description of minimum requirements for the safe and effective administration of ECT. As part of this project, a state-wide consultation involving both public and private hospitals was undertaken in 2008 around ECT practices and a Conference and Practical Workshop was also held for clinicians to support them to gain practical ECT skills and knowledge.