Presentation describing the DMA INSIGHT programme and its use in collaboration with St Andrews Hospital Charity to develop person centred integrated care pathways - presented at International Forensic Conference - UCLAN

1. Collaborative development of a
Forensic Secure
Integrated Care Pathway:
towards a reduction in length of stay and an
improvement in the patient experience
Colin Doyle & Debra Moore

2. St Andrews – service background
• challenging behaviour
• secure care pathways
• mental health
• learning disability, autism
• brain injury
• adolescents
• men, women
• older people

3. Service Background
The Therapeutic Milieu
Physical
Relational Person Positive
Security Procedural Cultural
Security Centred Behaviour
Security Values &
Approach Support
Behaviour
A charity leading innovation in mental health

4. Debra Moore Associates
• Organisational Development
• Strategic Planning
• Service improvement and redesign
• Business development
• Training including blended learning
• Networks and forums

5. A partnership on many levels
• Between two
organisations
• Across different sites
and services
• Across professionals
• BETWEEN PEOPLE WHO
USE OUR SERVICES,
THEIR FAMILIES AND
STAFF

6. Drivers?
• Policy Context – high quality,
safe, person centred care
• Increased user involvement
• Need to articulate the Care
Pathway or ‘patient journey’
• CQUINS
• QIPP
• Regulation CQC

7. Common conundrums for health services
• How to evidence the care pathway and delivery of timely and effective
interventions
• How to ensure staff have basic knowledge and understanding of care
pathway, assessments, interventions, tools etc
• How to ensure all staff are working to national and organisational policies
and procedures
• How to ensure all staff are aware of and acting in accordance with good
practice guidance and research
• How to ensure all paperwork is the right paperwork!
• How to inform staff development – knowing where the needs and
strengths lie within the workforce
• How to increase user involvement and promote ‘choice and voice’
• How to create a easy to use system that can manage knowledge and
provide relevant data to measure performance

8. What can happen?
• Confusion
• Variable quality
• Not person centred
• Dehumanising

9. Using appreciative inquiry
– taking a strengths based approach
• When health care is patient
centred – what does it look
like?
• How does it feel?
• Need to create a compelling
picture and move towards it

10. Tell me about a time……
• Ask all stakeholders
• Interview each other
• Take a ‘slice’ of the organisation
• Hear the patient and their carer

11. Understanding the patient’s journey
Pre- admission Admission Person centred
care planning

12. Understanding the patient’s journey
Treatment Pre Discharge Post Discharge
phase Planning Support

13. 3 BIG phases
Moving Moving Moving
in through out

14. DMA INSIGHT Programme
• A dynamic process
• Bespoke to the service
• Captures the ‘real’ patient
journey (care pathway)
• Version for staff
• Version for patients and carers
• Contains local and national
resources
• Blended learning

15. DMA INSIGHT - ONLINE
• Using new techniques to
engage
• Reduce ‘ring binder’ culture

16. Summary
• Puts the patient and their
experience at the centre;
improving patient experience
• Clarifies the care pathway
and works towards a
reduction in length of stay
• Supports the ‘frontline’ with
tools, resources and learning

17. Any questions?

18. More information
debra@debramooreassociates.com
CDoyle@standrew.co.uk