Quality Improvement Presentation

Improvement of the Crisis Prevention Tool and Safety Plan for the
Kekela Mental Health Unit at Queens Medical Center

By: Kristina, Lauren, Darren, Gary, & Amy

PICOT - Population / Patient Problem

Who is your patient?
Adult mental health clients in an acute care setting
What is the patient problem?
Current assessment tool is not patient-friendly
(lengthy, cumbersome)
Poor patient compliance in completing crisis
prevention assessment and development of crisis
plan
Poor accessibility of crisis plan for nurses
Safety issue

PICOT - Intervention
What do you plan to do for the patient?
Revise the current crisis prevention assessment form
to be more streamlined and user-friendly.
Utilize personalized crisis prevention information
provided by patient in order to prevent/minimize
crisis by recognizing warning signs and deescalating a situation through coping strategies.

PICOT - Comparison
What is the alternative to your plan?
Keep the crisis assessment tool that is (not) being
used/utilized
Utilize different tools
State of Hawaii Department of Health, Child and
Adolescent Mental Health Division
National/International:
Nonviolent Crisis Intervention Training (CPI)
Resource Guides for creating Safety Plans
Crisis Assessment Tool (CAT)

PICOT - Outcome & Time

What outcome do you seek?
New tool to be patient-nurse friendly (compliance)
A simplified, concise crisis prevention assessment
tool
Implement on daily census
What is the time frame?
Implement - immediately
Analysis - at least 1 month

Evaluation
Verbal feedback
Measure utilization
Safety plan on file for each patient
Measure simplicity
Pt. and nurses verbalizes understanding
Measure ease of use
Decreased amount of time to complete
safety plan

References
Change your team [blog]. (2013). Retrieved from: http://changeyourteam.com/wpcontent/uploads/2013/09/cliff-blog-shutterstock_123670591.jpg
Child and Adolescent Mental Health Performance Standards. (n.d.). Retrieved September
14, 2015, from http://health.hawaii.gov/camhd/files/2013/07/Orange-Book.pdf
CPI.(2012). Nonviolent Crisis Intervention Participant Workbook. Milwaukee, WI
Data Assessment Registry Mental Health & Addiction.Crisis Assessment Tool (CAT). Retrieved
from https://dmha.fssa.in.gov/DARMHA/Documents/SFY2016ANSAManual_08282015.pdf
.
Heckemann, B., Zeller, A., Hahn, S., Dassen, T., Schols, J., & Halfens, R. (2015). The effect
of aggression management training programmes for nursing staff and students working in
an acute hospital setting. A narrative review of current literature. Nurse Education
Today, 35(1), 212-219. doi:10.1016/j.nedt.2014.08.003

References, Cont
Mid-Valley Behavioral Care Network. Personal Action/Crisis Prevention Plan. Retrieved
from:
http://www.mvbcn.org/home/mv1/smartlist_144/personal_actioncrisis_prevention_pla
n.html
Rings, J. A., Alexander, P. A., Silvers, V. N., & Gutierrez, P. M. (2012). Adapting the Safety
Planning Intervention for Use in a Veterans Psychiatric' Inpatient Group Setting. Journal
Of Mental Health Counseling, 34(2), 95-109.
Roberts, A. & Ottens, J. (2005). The seven-stage crisis intervention model: a road map to
goal attainment problem solving, and crisis resolution. Retrieved from:
http://btci.edina.clockss.org/cgi/reprint/5/4/329
The Parent/Professional Advocacy League (PPAL) & Massachusetts Behavioral Health
Partnership (MBHP) (2011). Crisis Planning Tools for Families: Companion Guide for
Providers. Retrieved from: https://www.masspartnership.com/pdf/Crisis-PlanningTools_Guide_for_ProvidersFinal.pdf