Learning from good practice and co-designing improvement in a specialist eating disorder setting
Eating disorders have devastating impacts on lives and present significant healthcare challenges. NHS England data reveal that despite more young people being treated for eating disorders than ever before, record numbers of under-19s are awaiting treatment. Services are under pressure to increase patient safety, shorten recovery times, reduce repeat admissions, and admit more patients. Therefore, healthcare improvement has much to offer specialist eating disorders services and much can be learned about the study of healthcare improvement in these settings.
This research developed from a quality improvement (QI) project designed to reduce naso-gastric tube (NGT) feeding under restraint at a 16-bed inpatient eating disorder unit for 12 to 18-year-olds. Staff had raised concerns about feeding under restraint and following a quality improvement initiative, incidences were reduced from a pre-intervention high of 56 incidences in one month, to two incidences in six months. While this demonstrates a significant rate of change, the impacts are not yet fully understood.
In this PhD fellowship, data collected via quantitative (service and patient records) and qualitative (ethnographic observation and interviews) methods will be used to examine how the NGT feeding policy change impacted patients and staff.
Findings will be used to design guidelines that:
- support replicable and scalable improvement
- address gaps in existing guidance.
Co-design methods will also be used to bring together staff, patients, and parents/carers to redesign dining room support and explore how stage of illness influences young people’s ability to contribute to the co-design process.