Health Career Model Cygnet Hospital Bierley [II]

Dear Denise

Thanks for your message, interest and ongoing support of Hodges' model. I've copied your query to Brian. It is marvellous to read of your career to date and how you have adapted the model to fit your needs.

I have some insight into PSI (psychosocial intervention) and feel that the model could certainly be used in your new post. I suppose (as ever) there are several caveats as you may have already found...

Chief among them is that your colleagues may be reluctant to follow your lead - asking for the evidence* to support safe and effective clinical use of Hodges' model?

The website and blog represent a call for research in Hodges model and similar approaches.

In support of Hodges' model in Bierley -

* 16 bed Acute Ward(male)
* 15 bed Complex Needs Ward (male)
* 15 bed PICU Ward (male)
* 15 bed Personality Disorder Service Ward (female)

- as you will be aware the model is very high-level and it does not dictate practice or philosophy. If adopted however the model can help assure (not guarantee) a holistic approach, as you have already found.

You may care to look at the current processes - care pathways - and map these using Hodges' model. Then look at the specifics of therapeutic modality and PSI (for example, specialised cognitive therapeutic/schema therapies personality disorder) on the unit and effects on the key (h2cm) elements -

INDIVIDUAL-GROUP
HUMANISTIC-MECHANISTIC

- and across the four knowledge domains.

On the blog, check the post 'labels' (on the right-hand side) for -

process,
practice,
purpose
and policy [4P's]. These posts may help also.

An often 'neglected' area is outcomes and outputs. Check what aspects of care (and outcomes) the commissioners of care are focusing upon? Public involvement, client and family engagement may be challenging aspects of care for you and your colleagues? You can also utilise the POLITICAL domain which in your work - as with the TEMSS/secure services posts is no doubt central. The focus on PSI is another crucial dimension SOCIOLOGY - POLITICAL, especially if family oriented? What areas do you want change? Should you concentrate your efforts on one care (knowledge) domain, or are there some inter-domain dependencies highlighted in the literature*?

What data do you have on your patient (referral) population (month-year?); your local (catchment area) population?

Hodges' model is a space - what can you fill it with?

What data do you already have? Sometimes this can come as a pleasant surprise, or a data-poverty shock? Who can you speak to internally - externally? Statistics, reports, intelligence? Is your organisation a learning organisation? (There are times to join in with the fashion game...) If so, does that include the clients and their families? Is anyone on a course and in need of a project? What does multidisciplinary team and integrated care (really) mean in your service? Has a staff member been away for 6-12 months, if so speak to them...

Your bed numbers:staffing ratios speak volumes to some people more than others (£...$) how does economics figure across Hodges' model? If it may help SWOT each domain?

Currently on the psychiatric nursing mail list there is a discussion on 'recovery' and employment-benefits. What does this mean for your care objectives and service overall?

If you still have any contacts at Kemple View or notes (essays) that you could possibly share please let me know. If you are interested in writing / collaborating on a paper I'd be happy to assist.

If there is a 'clinical development (governance) lead' in your new organisation it would help to get them on-board - then you are not out-on-a-limb. Your success thus far suggests you'll have this covered!

If you would like some views on your progress to date do not hesitate to tap my screen.

All the best to you and your colleagues Denise with your plans and for the holidays - 2008!

Keep in touch...

Peter J.
===========================================================
Peter,
Thanks very much for your speedy response, I have already met with my two charge nurses on the ward and we have agreed a way forward. There is of course much to do to ensure that we can introduce the model successfully, your answer will prove very useful. I would be happy to keep in touch and of course feel free to add my question to the blog if you think that this will be helpful to others.

Kind Regards
Denise Banks