SAFER-MH: FEASIBILITY STUDY OF A DISCHARGE PLANNING CARE BUNDLE

Care transitions are widely recognised as a vulnerable, high-risk stage in the care pathway with multiple professionals involved across sectors.In the UK, a large proportion of people who died by suicide have recently been discharged from secondary mental health services.Improving systems, processes and support during this critical period has the potential to be life-saving.Patients being discharged from inpatient mental wards often describe safety risks in terms of inadequate information sharing and involvement in discharge decisions.Through stakeholder engagement, we co-designed a care bundle intervention, SAFER Mental Health (SAFER-MH), to address these concerns through the introduction of new or improved processes of care.We conducted a feasibility study to understand whether a definitive trial for SAFER-MH is feasible and, if so, how it should be designed, and how many patients/wards should be included.A before-and-after feasibility study design with a 6-week usual care phase followed by 6-week intervention phase was conducted on three wards in the North of England.During the intervention phase, all participants received the intervention.We used quantitative (validated questionnaires, e.g.EQUIP, CTM) and qualitative (interviews) methods to assess the acceptability and feasibility of SAFER-MH.This study report presents the qualitative findings of using the Theoretical Domains Framework to assess and understand implementation with 16 clinician interviews conducted during the post intervention phase.The Framework analysis highlighted issues that can be used to guide future implementation of the SAFER-MH intervention, indicating that most clinicians felt they had the knowledge and skills to implement SAFER-MH.However, focus should be on integrating the intervention into standard practice to mitigate the effects of external factors such as ward acuity, which was identified as key driver for nonadherence.The findings highlight the importance of the development and embedding of targeted Behaviour Change implementation strategies in future studies.