Louch Gemma, Berzins Kathryn, Walker Lauren, Wormald Gemma, Blackwell Kirstin, Stephens Michael, Brown Mark, Baker John
School of Healthcare, University of Leeds, Leeds, United Kingdom.
Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford, United Kingdom.
JMIR Form Res. 2024 Apr 12;8:e53726. doi: 10.2196/53726.
Acute mental health services report high levels of safety incidents that involve both patients and staff. The potential for patients to be involved in interventions to improve safety within a mental health setting is acknowledged, and there is a need for interventions that proactively seek the patient perspective of safety. Digital technologies may offer opportunities to address this need.
This research sought to design and develop a digital real-time monitoring tool (WardSonar) to collect and collate daily information from patients in acute mental health wards about their perceptions of safety. We present the design and development process and underpinning logic model and programme theory.
The first stage involved a synthesis of the findings from a systematic review and evidence scan, interviews with patients (n=8) and health professionals (n=17), and stakeholder engagement. Cycles of design activities and discussion followed with patients, staff, and stakeholder groups, to design and develop the prototype tool.
We drew on patient safety theory and the concepts of contagion and milieu. The data synthesis, design, and development process resulted in three prototype components of the digital monitoring tool (WardSonar): (1) a patient recording interface that asks patients to input their perceptions into a tablet computer, to assess how the ward feels and whether the direction is changing, that is, "getting worse" or "getting better"; (2) a staff dashboard and functionality to interrogate the data at different levels; and (3) a public-facing ward interface. The technology is available as open-source code.
Recent patient safety policy and research priorities encourage innovative approaches to measuring and monitoring safety. We developed a digital real-time monitoring tool to collect information from patients in acute mental health wards about perceived safety, to support staff to respond and intervene to changes in the clinical environment more proactively.
急性精神卫生服务机构报告称，涉及患者和工作人员的安全事件发生率很高。人们认识到患者有可能参与到改善精神卫生环境安全的干预措施中，因此需要采取主动征求患者对安全看法的干预措施。数字技术可能提供满足这一需求的机会。
本研究旨在设计和开发一种数字实时监测工具（病房声纳），以收集和整理急性精神卫生病房患者对其安全感知的日常信息。我们展示了设计和开发过程以及基础逻辑模型和项目理论。
第一阶段包括对系统评价和证据扫描的结果进行综合分析、对患者（n = 8）和卫生专业人员（n = 17）进行访谈以及开展利益相关者参与活动。随后与患者、工作人员和利益相关者群体进行了多轮设计活动和讨论，以设计和开发该原型工具。
我们借鉴了患者安全理论以及传染和环境的概念。数据综合、设计和开发过程产生了数字监测工具（病房声纳）的三个原型组件：（1）一个患者记录界面，要求患者将其看法输入平板电脑，以评估病房的感觉以及情况是否正在变化，即“变差”或“变好”；（2）一个工作人员仪表板以及在不同层面查询数据的功能；（3）一个面向公众的病房界面。该技术以开源代码形式提供。
近期的患者安全政策和研究重点鼓励采用创新方法来衡量和监测安全。我们开发了一种数字实时监测工具，以收集急性精神卫生病房患者对感知安全的信息，以支持工作人员更积极地应对临床环境变化并进行干预。
