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Improving service user self-management: Development and implementation of a strategy for the Richmond Response and Rehabilitation Team

Research output: Contribution to journalArticle

Julie Sanders, Joanne Fitzpatrick

Original languageEnglish
Number of pages7
JournalBMJ Open Quality
Issue numbere000126
Early online date25 Nov 2017
Publication statusPublished - Nov 2017


King's Authors


Community rapid response and rehabilitation teams are used to prevent avoidable hospital admissions for adults living with multiple long term conditions and to support early hospital discharge by providing short-term intensive multidisciplinary support. Supporting self-management is an important service intervention if desired outcomes are to be achieved.
A Care Quality Commission inspection of the Richmond Rapid Response and Rehabilitation Team in 2014 identified that self-management plans were not routinely developed with service users and reported this as requiring improvement. This quality improvement project aimed to develop and implement a self-management strategy for service users, and for 90% of service users to have a personalised self-management plan within three months.
The quality improvement intervention used the Plan-Do-Study-Act model comprising: 1) the development of a self-management plan, 2) staff education to support service users to self-manage using motivational interviewing techniques, 3) piloting the self-management plan with service users, 4) implementation of the self-management plan, and 5) monthly audit and feedback.
Evaluation involved an audit of the number and quality of self-management plans developed with service users, and a survey of staff knowledge and confidence to support service users to self-manage. Following implementation of the intervention, the number of self-management plans developed in collaboration with service users increased from 0 to 187 over a four week period. Monthly audit data confirmed that this improvement has been sustained. Results indicated that staff knowledge and confidence improved after an education intervention.
Quality improvement methods facilitated development and operationalisation of a self-management strategy by a community rapid response and rehabilitation team. The next phase of the project is to evaluate the impact of the self-management strategy on key service outcomes including self-efficacy, unplanned and emergency hospital admissions and early discharges.

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