Shift Happens:staff views on the role of creative approaches in quality improvement

Background reviewPartnerships with a range of cultural organisations have encouraged more creative approaches to service delivery within Mersey Care NHS Trust. An emergent evidence base has begun to point to a positive impact on the quality of care. However, evidence was largely anecdotal and highlighted a gap in how staff viewed these approaches.MethodSemi-structured interviews were conducted with a purposive sample of Trust staff. Data was analysed using grounded theory against the three dimensions of quality: patient experience, safety and effectiveness. ResultsWithin patient safety staff identified the positive ‘affect’ on mood for service users and also the resulting ‘effect’ on the ward environment, from the subsequent reduction in challenging behaviour. Staff used creative approaches to manage critical risk points, such as discharge, describing participation as giving ‘stabilisers’ and ‘bridges’ to reintegration. Effectiveness of care co-ordination emerged from the discovery of people’s ‘legacies’ and demonstration of physical and cognitive abilities that were assumed lacking. Interviews also generated examples of participation leading to growth in social networks and subsequent increased independence. Although many staff viewed these approaches as integral to care, other responses were mixed and for a smaller number of staff approaches were a ‘diversionary activity’. Conclusions Despite the question of how far the use of creative approaches are viewed as integral to care, for many staff the use of cultural partnerships appears to have a significant value. Much of the literature looking at the impact of creative activities on mental health points to individual benefits. However, these findings point to a wider value, firstly for enhanced care planning and secondly for a positive risk management discourse. Moreover, they appear to have the potential to shift patterns of re-admission in supporting sustained positive mental health.