Closing the equity gap as we move to the elimination of seclusion: Early results from a national quality improvement project.

Autor:	Bensemann C; Mental Health and Addiction Quality Improvement Programme, New Zealand Health Quality and Safety Commission, Wellington, New Zealand., Maxwell D; Mental Health and Addiction Quality Improvement Programme, New Zealand Health Quality and Safety Commission, Wellington, New Zealand., O'Keeffe K; Mental Health and Addiction Quality Improvement Programme, New Zealand Health Quality and Safety Commission, Wellington, New Zealand., Tresize L; Health Quality Intelligence, New Zealand Health Quality and Safety Commission, Wellington, New Zealand., Wairama K; Mental Health and Addiction Quality Improvement Programme, New Zealand Health Quality and Safety Commission, Wellington, New Zealand., Keelan W; Mental Health and Addiction Quality Improvement Programme, New Zealand Health Quality and Safety Commission, Wellington, New Zealand.
Jazyk:	angličtina
Zdroj:	Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists [Australas Psychiatry] 2023 Dec; Vol. 31 (6), pp. 786-790. Date of Electronic Publication: 2023 Sep 29.
DOI:	10.1177/10398562231202125
Abstrakt:	Objective: Use of seclusion within mental health inpatient facilities is harmful for consumers and staff, but it is still used in many Aotearoa New Zealand and Australian facilities, at higher, inequitable rates for the indigenous populations of both countries. We report early results from a national programme to eliminate seclusion in mental health services in Aotearoa New Zealand, using a bicultural approach to reduce inequity for Māori. Method: The 'Zero Seclusion: Safety and dignity for all' programme, with programme teams nationwide, developed a co-designed bicultural change package combining Māori cultural and Western clinical interventions, incorporating quality improvement methodologies. Outcome measures included seclusion rates, duration, and average number of episodes per person admitted, by ethnicity, with a focus on equity. Results: Nationally, rates of seclusion for Māori reduced from the 12-month (to August 2019) baseline mean monthly rate of 7.5% to 6.8%, sustained from late 2020 to September 2022. The duration of seclusion for Māori reduced by 33% (4.5 h at baseline to 3.0). Conclusion: A focus on inequity for Māori in use of seclusion, and a bicultural approach with cultural and clinical interventions, has been associated with a national reduction in rates and duration of seclusion for Māori. Competing Interests: DisclosureThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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