20 Jan 2016

You say Star Wards, and I say Safewards

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swsw-final

 

By Geoff Brennan

 

“You say Star Wards, and I say Safewards.”  

I was recently asked for information or articles about Safewards and Star Wards working together.  Well, I hate to say it – but there aren’t any. So here I am, trying to plug that particular gap.

Actually, I have been mulling over this for a while. Being involved with both has (questionably) placed me in a good place to put some shape to it.  You can disagree with my thoughts – it’s a free world- and do feel free to add your own.

As a person who thinks in metaphors (I blame English Teachers), I see the two SW’s as siblings in the great family of mental health improvement. Star Wards is the pubescent and pimply older, being born 12 years ago.  Safewards is the also loved, just out of nappies, younger, being not yet three years old. Like many younger siblings, Safewards has both learnt and benefited from the path carved out by Star Wards, and Star Wards looks proudly and wonderingly on as Safewards piles through the milestones with youthful abandon.  What is very clear about this particular sibling relationship is that there is no rivalry, no rancour and no elbowing each other for the spotlight. They’re not Cane and Able, people! These are siblings who see each other as a support and comfort against a complex and difficult world.

All very lovey-dovey, but there are things that mark them as different and they do both understand that a ward may see three as a crowd and prefer to hang out with one or the other.  More on that later.

Let’s start, however, with the common DNA of the pair. Let’s start with what unites them. In the age old tradition of someone who is getting tired of his own voice, I’ll do this with bullet points.

  • Crucially, both see ward staff and patients as the holders of the solution, not the source of the problem.
  • Both believe wards CAN change and that ward staff and patients WANT them to be as good as they can be.
  • Both see ward staff and patients as the key leaders/agents/champions of any change. Indeed, I feel both would agree that the ward staff and patients’ are the ONLY ones who can really make change happen
  • Both have a philosophy of small, incremental changes to create “betterness”[1].
  • Both can be understood and implemented without the need of a degree in psychology, medicine or astrophysics. From this, neither requires further training – the skills are already there in ward staff and patients.
  • Both suggest wards monitor, understand and control changes for themselves, but neither dictates a set audit, action plan, learning set, change model, process, quality assurance benchmark thingy.
  • Both give away all their stuff free on websites and use social media to make sure the free stuff is as available as possible to whoever wants it.

 

 

Perhaps the best summary of all of the above is a quote from Canadian Nurse Tamara Dube – to the effect of:

“They light a fire IN staff and patients’ and not UNDER them.” [2]

So, a pair of Zen monks calling on wards to look for the path of inner enlightenment? Well, no, they’re not that blind to the realities of the world. I could have said that neither thinks that change is easy – but that would be ”harshing the buzz”, so to speak.

Not satisfied? You’re waiting for the “but” aren’t you? Ok, if you must! Here’s what I think.

Getting bored again, so back to bullet points.

  • The obvious difference is where they come from. Star Wards is led by the incomparable Marion Janner, who got her knowledge of wards from being on one and becoming a focal point for people who wanted to make them more human for both patients and staff. Safewards is led by the incomparable Len Bowers who got his knowledge from doing shifts on them and extensively researching what happens to make them unsafe and what can be done to make them safer.
  • From this comes a difference in “angle”. Star Wards says wards should be more therapeutic for all. This involves: having more activities; better use of talking therapies; better access to the rest of the “community” (including the web pets/animals). Safewards says the wards should be SAFER for all. This means adopting a set of interventions that softens the power differences between the staff and patients; helps both groups to address everyday flashpoints; and encourages the staff to release the potential of both themselves and the patients’ to help each other be safe.
  • To clarify the” angle”, you might be tempted to make the argument that Star Wards addressed the patient agenda and Safewards the staff’s – but I think that would be too simplistic. They are each much more inclusive than that and the differences are simply that of angle, not of goal. In reality, they both focus on introducing ideas of benefit to all.
  • Although they both advocate a number of small, incremental changes rather than a single big change, they do this in very different styles. Star Wards has a starting menu of 75 ideas and a back catalogue of hundreds with an open invitation to share good ideas and practice to grow the back catalogue. It doesn’t dictate what to adopt or where to start. Chuck yourself in and have fun. In contrast, Safewards has a starting menu of 10 handpicked interventions. They have been crafted, honed and polished to perfection. There is a back catalogue of over 100 more, but Safewards would advise wards to consider the starting shiny 10 first. The Safewards message is -have fun, but in a controlled “think of your heart Nigel” -way.
  • I think one of the biggest differences (and one that the Trust Board may well go “ooh” at) is the combined evidence base. Star Wards is qualitatively evidenced by over 600 wards adopting the Star Wards changes and then undergoing a review that showed wards saying “that was therapeutic”– and reflecting on increased satisfaction, less aggression, and a lot more fun activities. Safewards attracted a huge research budget and did a kick ass quantitative randomised control trial (listen- can you hear the Board going “ooh” now?). The evidence was outstandingly in favour of the 10 handpicked interventions making wards safer and smashed the “but is it evidence based” googly over the boundary and into the car park.

There are other differences: Safewards starts with younger adult wards, Star Wards are any old ward really (and care homes for some stuff); Safewards has gone international and wants to take over the world [3] while Star Wards is as British as a Royal corgi [4].

Also, while both have websites, Safewards is an understandable, friendly but essentially sensible website full of facts and suggestions while Star Wards is an understandable, friendly but essentially flamboyant website full of detailed praise for the wonderful ideas and work of both staff and patients’.

The big, trunk waving, bun stealing question in this conversation is, of course, can they be done on a ward together. The simplest answer to this is that they can. The more difficult question is – what does your ward need?  I think if you can answer that question, the SW siblings can give you a nice solution at minimal cost. Alternate, you may find one of the siblings to be more to your present taste than the other. The good thing is they won’t go crazy if you do.  In fact you might even find them cheering you on from the side-lines!

I think that’s enough – and I’ve run out of bullet point.

But much more importantly – What do you think?

 

 


 

[1] Is that even a word?  Where are those English Teachers when you really need them!

[2] I don’t care if some other famous person said it before Tamara – as far as I’m concerned SHE SAID IT and it’s just another example of how brilliant ward people are. So don’t send me a link to any famous quotes websites, If you do, I’m sticking my fingers in my ears, closing my eyes shouting “la la la la” at the top of my voice.

[3] Muwahahah!

[4] Hey, we have to have dogs in here somewhere

 

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