Staff on Aurora Ward recognised that although they were busy dealing with typical organisational pressures, there were few opportunities to use the creativity of staff and service users in improving the operation of the service.
Aurora Ward used the Team Recovery Implementation Plan (TRIP) to encourage the development of recovery-oriented practices including the use of recovery stories, co-produced ‘ward house rules’, welcome meetings, parties when someone was moving on, and ward round self-reporting.
Although TRIP is not explicitly set up in terms of quality improvement, it provides a systematic framework for improvement that aligns to quality improvement principles. A TRIP action plan is broadly similar to a Driver Diagram and PDSA cycles, in supporting teams to co-produce, co-deliver and co-review the ongoing improvement plan process. There are four key elements – an overview of team resources, benchmarking the 10 key organisational challenges, agreeing the top three priorities for action, and systematically reviewing and resetting goals. An evaluation of the programme was completed and the information was spread to other services using the CQUIN (Commissioning for Quality and Innovation) as a framework for planning and measurement.
After using TRIP on Aurora Ward, comparing 2011 and 2012:
Incidents of self-injury fell from 39 to 8
Hours spent in seclusion fell from 987 to 483
The number of residents who moved on increased from 3 to 14
Staff sickness absence decreased
Physical assaults of staff decreased from 34 to 27
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Promote the process of using TRIP, rather than the tool itself
Community teams may have to use service user representatives, to reflect the diverse views of an entire community team caseload
TRIP is most effective in an organisation that is actively committed to a recovery culture.