Improving Care in Self-Harm HIT review of 2013-14

Salena Williams, Director of the Improving Care in Self-Harm Health Integration Team (STITCH HIT), looks back at the team’s work in 2013-14.

During our first year, we have been working hard to improve self-harm
care and treatment, and reduce suicide across Bristol. Through collaborating across
organisations and with service users we have created a Bristol-wide self-harm surveillance
database which gives real time information about self-harm from the Children’s
Hospital, Bristol Royal Infirmary, Southmead and Frenchay Hospitals. We have collated
all national evidence and literature relating to good self-harm care across the
UK to understand best practice and evidence-based care. We have standardised all
self-harm assessment documentation across Bristol hospitals.

In a large collaborative project, service users have been involved
in shaping the service and evaluating Emergency Department (ED) care using experience-based
design techniques. Over the next year we hope to consolidate this work to improve
care for self-harm in Bristol Emergency Departments. We have begun to create a resource
pack for self-harm patients and introduced personal care plans at ED reception.
Environment was also a key area for improvement: we are working with nationally
acclaimed animators to create and show information programmes in waiting areas.

Alongside all this, training has been a key issue in self-harm care.
We are providing teaching to our ED staff and GPs and we are hoping to offer a seven
day psychiatric nurse service in the BRI, with the aim that self-harm care follows
NICE guidance. The next stage is to ensure care improvements are consolidated in
Emergency Departments at Southmead Hospital and the Bristol Royal Infirmary. We
will continue to monitor the self-harm register and work towards enhanced psychiatric
liaison service in the Emergency Department. We aim to develop good practice and
close communication with GPs and Emergency Departments and undertake further research
utilising the self-harm register.