Secure mental health units at Rowanbank Clinic and Leverndale Hospital developed a comprehensive record to capture information on adult patients’ physical health and wellbeing.
Patients in forensic services often face barriers to health improvement. These include weight management issues, smoking, restrictions on physical activity and side effects of medication. Information about patient health, such as the numbers of patients with diabetes, can be inconsistent and difficult to gather. To address these issues, the Forensic Health Improvement and Equalities Group decided to introduce the Patient Health Improvement Record (PHIR). The PHIR will allow the units to set benchmarks, to support service planning, and help individuals to set their own achievable health improvement priorities.
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A researcher helped to design the 50 page PHIR. The record includes tick box options and space for comments from staff and patients. A traffic light scoring system is used to highlight immediate problems and longer term issues. It also provides for different scenarios, as a patient’s capabilities may vary depending on their mental state. They may be relatively independent, may require prompting or supervision, or may be unable to complete the health record themselves. The health record collects detailed information on:
Key workers will complete the PHIR of one or two of their patients by gathering relevant information, such as occupational therapy assessments. They will choose appropriate times to get the patient’s input, taking account of individual issues such as a short attention span. The PHIR must be completed in 4-6 weeks to give a snapshot of the individual’s current health and wellbeing. The PHIR will follow patients after they have been discharged or transferred so that health improvement work can continue once they’ve left the care of the secure units. It will be reviewed every few months.
The PHIR will help key workers to:
The PHIR data will help forensic service managers to make informed decisions about resource allocation, identify demographic issues and develop appropriate support for patients. Cross-service data will also help specialists such as speech and language therapists, who only see extreme cases, get a picture of wider prevalence.
Feedback from the pilot was very positive. Both staff and patients could see the merits of the PHIR and were not put off by the process. The project’s researcher will build a database using individual records and will report their initial findings in 2013.
Some personal information can be difficult to obtain, especially where patients are disconnected from their families, but patients and staff were able to discuss many areas of health openly and in detail.
In the wake of the pilot, the group plans to roll out the PHIR in the two secure mental health units at Rowanbank Clinic and Leverndale Hospital.
For a copy of the PHIR or a PowerPoint introduction to the PHIR, email:
Tommy Harrison Senior charge nurse Directorate of forensic mental health and learning disabilities Pine Ward Rowanbank Clinic 133c Balornock Road Glasgow G21 3UL
Tel: 0141 232 6483 Email:
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