Improving the A&E experience of self-harm patients

The Improving Care in Self-Harm (STITCH) Health Integration Team held a ground-breaking ‘shared voices’ conference in October where Bristol Royal Infirmary Emergency Department (ED) staff and self-harm patients came together for the first time.

Self-harm is one of the biggest risk factors for suicide, and STITCH aims to help lower suicide rates by improving emergency department care and GP services, and enabling patient-focused changes to services.

At the event, the Self Injury Self Help (SISH) group presented the findings from an in-depth questionnaire, including quotes and input from a wide range of people who had attended the emergency department following self-harm.

The conference saw staff and patients working together to identify the challenges at each stage of the emergency care pathway for self-harm patients. These included reception, triage, physical care, psychiatric care and discharge.

As a result of these discussions, ideas to improve the experience included:

• A crisis card for returning self-harm patients. This would give ED staff immediate information about the patient and their care needs
• A bite-size live teaching and training pack for staff in ED
• A patient resource pack which would include information on local services and how to get help

STITCH will be taking each of these ideas forward in the coming months. Salena Williams, STITCH Director and Senior Psychiatric Liaison Nurse at Bristol Royal Infirmary, said of the event: “Understanding the view points of everyone involved in self-harm, both the patients and the staff, allowed us to make bespoke changes for each department according to their needs. This included simple things such as leaflets, right through to education.”

Salena organised the shared voices conference and the evaluation of the two emergency departments in Bristol. She also featured on Radio 4’s Woman’s Hour on Friday 29 November as part of a discussion on the recently released research which reveals varying levels of quality of care for self-harm patients in Emergency Departments across Britain (Cooper et al, 2013, BMJ).

For more information about STITCH please contact Salena Williams, [email protected] or phone 0117 342 2777 or visit the STITCH HIT page.