The team wanted to meet national guidelines on improving physical wellbeing for people using mental health services, including the large proportion of inpatients with high Body Mass Index. Baseline data revealed service users can gain an average of 2.5kg in weight, during a one month admission to hospital.
Inpatients often gain weight because of decreased activity and the effects of some prescribed medications.
The Newham Centre for Mental Health, part of East London NHS Foundation Trust, is a mental health unit in a borough with poor physical health outcomes.
Steve Yarnold and Simon Tulloch, inpatient clinicians, worked with Genevieve Holt, a quality improvement colleague and dieticians, psychologists, physical health specialists and service users to lead a new approach to improve the physical health of service users.
The multi-disciplinary project team coordinated efforts of healthcare staff, with external catering workers and local fitness experts, to tackle the broad range of issues that influence inpatient weight gain. The team developed a new electronic physical health assessment form to monitor physical health,which provides data for improvement. Health care staff were trained to collect accurate weight information. They introduced new menu choices and physical activities.
The team used a driver diagram to provide a structured logical approach. They applied the Model for Improvement and a series of PDSA cycles to work on several change ideas. These ideas included ‘easy wins’ such as buying accurate weighing scales and providing information leaflets.
As yet, there is not a significant change in the main outcome data. However, the team streamlined processes to ensure accurate and timely weight measurements. The team developed a new electronic physical health assessment form for all staff, which facilitates data extraction.