Reducing Restrictive Practice Collaborative

September marked the close of our 18-month Reducing Restrictive Practice (RRP) Collaborative. Over the course of the collaborative 38 mental health wards were supported by the National Collaborating Centre for Mental Health (NCCMH) Quality Improvement (QI) Coaches to introduce changes on their ward to reduce restrictive practices.

Over 300 change ideas were generated and tested, data was collected and used to measure the impact of the changes and teams collaborated with patients in many ways. By the close of the programme these changes had resulted in 24 out of 38 wards seeing reductions in their use of restrictive practice ranging from 25% to 100% in one or more measure (number of physical restraints, seclusions, and rapid tranquilisations).

This was the first time a QI approach had been implemented at national scale within mental health services in England to tackle a complex safety issue. The programme has sustainably reduced the use of restraints, seclusions and rapid tranquilisation by 15% across the 38 wards (from 26 provider Trusts) that have taken part.

Even for teams who didn’t see a quantitative improvement in their data, significant qualitative improvements have been seen across the programme. Wards have made improvements to the physical space, put person-centred care at the forefront of what they do and worked tirelessly to make vital improvements to the culture on their wards. The collaborative has seen all those involved report improvements in both patient and staff experience, and some wards have also told us that patients believe their involvement in the project has supported their recovery.

We are currently underway with our second national QI collaborative which uses a similar approach to improve sexual safety on inpatient mental health wards.

For more information and resources related to both national QI collaboratives, please visit: Reducing Restrictive Practice Collaborative

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