The State Hospital

The State Hospital, Carstairs, Lanark ML11 8RP
Phone: 01555 840293 Fax: 01555 840024 email:

High Quality Patient Care and Treatment

In this section:


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Quality Assurance and Improvement Strategy

The State Hospital’s quality vision is to achieve continuous improvement in the provision of safe, effective and person-centred care for patients and carers.  A draft strategy for 2017/20 was produced in March 2017 outlining high level goals and objectives for implementing assurance as well as systems and mechanisms that contribute to quality enhancement.  The draft will undergo wider staff engagement in 2017/18.

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Integrated Care Pathway (ICP)

The Hospital ensures that Integrated Care Pathways (ICPs) are being used to bring about improvements in patient care.  Key interventions continue to be recorded on a dedicated ICP database from which variance analysis and completion reports are generated and disseminated.

In 2016/17, 51 interventions were monitored monthly for annual and intermediate patient case reviews, and a significant piece of work was undertaken to implement a discharge variance analysis tool that will allow the Hospital to measure that every patient is being discharged with the same high quality information to enable a more seamless transference of care.

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Clinical Effectiveness

During 2016/17 the Hospital continued to promote and support continuous quality improvement throughout the organisation with a focus on ongoing audit of clinical practice and research to advance and promote clinical and evidence-based practice, national guidelines and standards, and Integrated Care Pathways (ICPs). 

A programme of clinical effectiveness activity is well established which is linked to the Local Delivery Plan and Clinical Model as well as national guidance.  The programme was updated during the year to include proposed clinical audit projects and re-audits for 2017/18.

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Clinical Supervision

Clinical supervision continues to be delivered to clinical staff across all disciplines.  Current provision includes a combination of 1:1 and group supervision. 

Within nursing, the number of 1:1 sessions that were delivered during 2016/17 decreased by 171 sessions compared to the previous year, the number of group sessions decreased by 31 over the same period, and a total of 255 nurses (74%) engaged in formal supervision sessions during 2016/17 (a decrease of 1% from 2015/16).

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Clinical Audit

Clinical audit within The State Hospital incorporates both national and local priorities. During 2016/17, 19 clinical audits were undertaken, compared to 14 the previous year. These audits enabled performance to be reviewed and improvements to be made:

Audit Title

Lithium Audit

CPA Documentation Audit

PRN Medication Audit

POMH Topic 7e – Lithium Monitoring

Antimicrobial Audit

PMVA Seclusion Audit

Prescription Sheet Audit

T2/T3 Audit

Child Visit Audit

Record Keeping Audit

Grounds Access

Named Person

Advance Statement

Medication Trolley Audit

POMH 16a Rapid tranquillisation in the context of the pharmacological management of acutely-disturbed behaviour

Seclusion Notification Form Audit

Audit the Completion of PANSS

Post PMVA Physical Intervention Audit

PMVA Observation Level Audit

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National Standards and Guidelines

New guidelines and standards continue to be evaluated and implemented. These include relevant national standards for Healthcare Associated Infection (HAI) and clinical guidelines such as schizophrenia and obesity. There were 212 new publications produced in 2016/17; 62 of these were deemed to have some relevance to the organisation. 

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Research is core to the business of The State Hospital in terms of pursuing evidence based practice.

The role of the Research Committee is to support, encourage and promote research, and to ensure the quality and dissemination of research projects associated with The State Hospital. The Committee also plays a key role in the statutory research governance responsibilities of The State Hospitals Board for Scotland, and conducts this role in line with the Research Governance framework of the Chief Scientist Office.

2016/17 saw a continued focus on the dissemination of the wide range of excellent research and evaluation conducted by staff at The State Hospital. Highlights include the ongoing popularity of both our State Hospital Research and Clinical Effectiveness Conference (95 attendees, May 2016) and the national Forensic Network Research Conference (55 attendees, November 2016) which included considerable contribution from State Hospital staff. Both conferences received excellent feedback from delegates.

During the year, The State Hospital’s Research Strategy was updated for 2016/20 and 22 research publications were produced (14 in 2015/16).

The Research Funding Committee takes decisions on research funding requests, informed by a full review of the scientific merit and ethical standards of a proposed project by the Research Committee.

The Research Committee Annual Report 2016/17 provides details of activity and achievements over the year.

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Eat Safe and Healthy Living Awards

Following positive inspections in March 2017, the Hospital retained: the Eat Safe Award for Excellence in Food Hygiene (for the sixth year running); and the Healthyliving Award and Healthyliving Award Plus for Promoting Healthy Eating. Feedback related to the good condition of the main kitchen, excellent practices, comprehensive training and the knowledge of staff.

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Photo: Campus