What is the challenge your project is going to address and how does it connect to the theme of 'How can we improve across system boundaries?​

In line with key guidance from Healthcare Improvement Scotland and the Scottish Patient Safety Programme we are aiming to improve responsiveness to acute distress, to reduce restrictive practice and embed trauma-informed culture in inpatient wards. Training on these principles can be hard to deliver within mental health settings: either removing staff from their workplace or taught in a less immersive environment where it is harder to guarantee a realistic environment.

Staff attended instructor training from Maudsley Learning on using virtual reality (VR) headsets to provide simulation sessions with expert-led facilitation involving challenging clinical scenarios . We were loaned VR headsets and have used them to train over fifty staff in trauma-informed care and reducing restrictive practice. This gained positive feedback from attendees.

Now the pilot is over, we hope to purchase equipment to enable our Quality Improvement (QI) and simulation teams to collaborate to create bespoke resources to meet training needs.

What does your project aim to achieve?

We aim to train all qualified staff in the principles of trauma-informed care using the VR simulation training within six months of them starting in post. Starting as a newly qualified member of staff in mental health settings can be daunting, and we would envision that this training would allow staff to gain a high-quality, immersive learning experience which provides them with the skills and attitudes needed to work with patients in a person-centered way at the very start of their career.

How will the project be delivered?

This project would be collaborative between the Lothian Mental Health QI and Simulation teams and appropriate Education and Nursing Management Leads. The mental health simulation team would undergo training in healthcare simulation, briefing and debriefing (delivered in-house), and work alongside nursing recruitment to offer the course to newly qualified staff.

Once all newly qualified nursing staff have been trained, the expectation would be for the VR training to be offered to all eligible staff.

We will evaluate the impact of the training on practice using a combination of qualitative and quantitative methods. We will also monitor data regarding inpatient harms including self-harm and violence and aggression as well as the use of Continuous Interventions and Seclusion.

How is your project going to share learning?

We will share results from the project locally, through presentation at the NHS Lothian Mental Health Quality Improvement and Clinical Innovation Forum.

We will share outcomes nationally via presentation at Scottish Patient Safety Programme Annual Learning Events. We would also plan to present at national conferences such as the NHS Scotland Event, The NHS Education for Scotland Annual Conference, and the Mental Health Nurses Forum.

Internationally, we would aim to showcase the work at the Royal College of Psychiatrists International Congress and the IHI International Forum for Quality and Safety in Healthcare.

We would aim to publish the work in an internationally recognised journal.

We would be keen to connect with the Q Community to share learning with the wider improvement community.