A pilot randomised controlled trial of enhanced support, openness and supervision for staff working on adult mental health wards
One year after randomisation, staff working on mental health wards that receive interventions aimed at enhancing support, openness and supervision for staff will experience lower levels of burnout than those working on wards that do not.
One year after randomisation, levels of staff turnover, staff sickness and use of agency staff will be lower on mental health wards that receive interventions aimed at enhancing support, openness and supervision for staff than on wards that do not.
One year after randomisation, the number of untoward incidents as recorded by incident report forms, will be lower on wards where staff receive enhanced support and supervision compared to wards that do not.
West London Research Ethics Committee 2, 20/09/2010, ref:10/H0711/62
Pilot randomised controlled trial
Primary study design
Secondary study design
Randomised controlled trial
Quality of life
Patient information sheet
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A modified cognitive analytic therapy approach to clinical supervision for ward staff in groups. Entitled 'Sharing, Openness and Supervision', this aims to change ward culture so that morale is improved with a positive effect on patient care.
The treatment arm will comprise one group per week of 1.5 hours clinical supervision for the ward team including staff members from all disciplines and from the ward leadership including at least one of ward manager, consultant and modern matron. Registered will be taken to record attendance and fidelity to this model. The clinical supervision groups will be run according to a Cognitive Analytic Therapy approach, adapted to this context.
Please note that there is only one treatment arm; the control arm is not active. The duration of the intervention will be one year and data on job satisfaction will be collected from ward staff at the beginning and end of the year. There will be no follow up after the end of the intervention, but routine ward data on incidents, recruitment and retention and sickness is routinely collected and may be analysed at a future point if appropriate.
Primary outcome measures
We will approach all staff who make up the ward establishment, from a list supplied by the ward manager. For these staff we will complete data collection on baseline measures prior to randomisation, using:
1. Maslach Burnout Inventory: a 15-item measure to assess emotional exhaustion, depersonalisation and personal accomplishment
2. Job Content Questionnaire: a 34-item measure to assess job-related stress
3. Basic demographic data: including age, gender and number of hours worked. We will collect this using a proforma specifically designed for the study.
Secondary outcome measures
We will also collect the following data from the ward and Trust databases:
1. Untoward incidents:
1.1. Total number of untoward clinical incidents on the ward including medication errors and near-misses in the 6 months prior to randomisation (March - August 2010)
2. Level of severity of clinical untoward incidents rated according to the IR1 form 5-point severity rating scale in the 6 months prior to randomisation
2. Staff costs (6 months prior to randomisation):
2.1. Agency and locum usage
2.2. Turnover of staff
2.3. Sickness rates among ward staff
2.4. Suspensions, disciplinaries
Overall trial start date
Overall trial end date
Participant inclusion criteria
Staff working on acute open mental health wards in the London Borough of Kensington and Chelsea. These wards are based at two inpatient units: St Charles Hospital and the South Kensington and Chelsea Centre for Mental Health.
Data will not be collected from patients at any point during the course of the study.
Target number of participants
100 participants across 6 wards
Participant exclusion criteria
Does not meet inclusion criteria
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
CNWL Trust Head of Arts Therapies
Central and North West London NHS Foundation Trust (UK) - Innovation Fund
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
Not provided at time of registration
Intention to publish date
Participant level data
Not provided at time of registration
Results - basic reporting