How does an accreditation programme drive improvement on acute inpatient mental health wards? An exploration of members' views.
BACKGROUND
Concerns have been raised about inpatient mental health care. An accreditation model can improve compliance with standards associated with improved quality of health care.


OBJECTIVE
To explore the effects of a standards-based, peer review, accreditation model on standards of care in acute inpatient wards and explore how staff achieved change.


METHODS
Quality of care was assessed by independent peer review against evidence-based standards in an accreditation process. Staff from the 11 wards receiving subsequent accreditation were interviewed to find out what processes had enabled accreditation.


RESULTS
Sixteen wards enrolled: four achieved immediate and 11 subsequent accreditation. The most common reasons for initial failure of accreditation were lack of psychological therapies or 1:1 time for patients, and presence of ligature points. Ward staff perceived the accreditation process improved communication, gave power to negotiate for resources, clear guidance how to practice, rewarded good practice and led to additional unrelated improvements in care.


CONCLUSIONS
Acute wards need to attend to basic safety and provide talking treatments (both formal psychotherapy and basic time spent with patients). An accreditation, peer-reviewed, standards-based process can enable staff to feel confident about improvements in the quality of care.
Baskind
Rob
R
North Yorkshire and York PCT, Clifton House, York, UK.
Kordowicz
Maria
M
Chaplin
Robert
R
D000068:Accreditation; D005260:Female; D019983:Guideline Adherence / Q000458:organization & administration / Q000592:standards; D006801:Humans; D007297:Inpatients; D007407:Interviews as Topic; D008297:Male; D017146:Models, Organizational; D010380:Peer Review; D011567:Psychiatric Department, Hospital / Q000592:standards*; D011787:Quality of Health Care; D013222:State Medicine / Q000592:standards; D006113:United Kingdom