This symposium details the current implementation and impact of Safewards, an intervention to change practice, in 18 inpatient psychiatric units across Victoria. The presentations explore key elements required for large scale intervention: policy drivers, multifaceted training approaches, adaption of tools for Australian contexts, intervention fidelity, consumer and staff experiences, measuring outcomes and strategies for sustainability. Stakeholder groups contributing to the symposium include: policy makers, local implementers, training providers, consumers and the independent evaluation team.

The symposium details how this international evidence is being applied in the Victorian context and in a variety of inpatient settings: acute, secure, aged and youth services. Elements of the process and outcome evaluation will show how data about fidelity of the trial is being captured, and fidelity achieved. We report evaluation results of the innovative approach to Safewards training, fidelity with the model and the experiences of staff and consumers.

Abstracts for individual presentations sessions (6X10 minutes followed by a stakeholder Q&A panel):

1. Reducing restrictive interventions in Victoria: Safewards trial within the RRI policy initiative
This presentation introduces the investment by the Victorian government in Safewards. In 2013 the Chief Mental Health Nurse called for expressions of interest from services, aiming to support local projects to reduce restrictive interventions. Based on grass roots interest in Safewards, the Victorian government then initiated a trial of Safewards in 18 inpatient units, across seven metropolitan and regional mental health service organisations.
Tracy Beaton, Chief Mental Health Nurse OR Anna Love, Acting Chief Mental Health Nurse

2. Safewards: what are the active ingredients?
This presentation details the aim, scope and elements of Safewards, as implemented Victoria. Safewards is a model and 10 point intervention, developed in the UK to reduce conflict events and containment interventions in acute inpatient settings (Bowers 2014). The paper includes a summary of the research evidence. Safewards is one of very few inpatient interventions subject to cluster randomised controlled trial, showing significant reduction in both conflict and use of seclusion. Development of a train the trainer program was designed to prepare ward staff to implement and champion the intervention elements.
Tess Maguire, Clinical Nurse Consultant, Facilitator of Safewards Trainer-the-trainer in Victoria

3. Experience of implementing Safewards with local use of training materials and resources
This presentation details the actual local process of implementation, from the earliest stage of engaging staff, through preparing teams for multifaceted practice change including training and organizational readiness, to achieving intervention fidelity. The paper concludes with plans and actions underway for sustaining practice change.
Lisa Spong, Safewards Project Lead, Bendigo Healthcare Group

4. Victorian Safewards innovations: adaptions for youth, aged and secure settings.
This presentation focuses on the approach taken in Safewards Victoria to adapting training and resources for local settings and in particular for youth aged and secure inpatient services. This paper highlights the novel contribution to the Safewards evidence base that is generated though the Victoria trial.
Rachel Gwyther, Safewards Project Lead, Monash Health

5. Results of the Safewards process evaluation: program logic, staff training outcomes, fidelity with the intervention.
This presentation details evaluation processes and outcomes of Safewards Victoria. Independent evaluation of the Victorian Safewards trial is being conducted by researchers from the University of Melbourne. Evaluation of training and the fidelity results for the 18 units are compared with the UK research.
Justine Fletcher, Evaluation Project Officer, University of Melbourne

6. Consumer Consultant* perspective on Safewards in a Victorian setting
This presentation report son acceptability and impact of Safewards, from consumer perspectives. Bridget Hamilton interviews the Peer Worker at Latrobe Health, a Champion for Safewards interventions in an acute inpatient unit, about the consumer experiences of Safewards model and specific interventions.
Doris Aquilina, Consumer Peer Worker, Latrobe Health

7. Stakeholder Panel for audience Q&A – 30 minutes
This longer session within the symposium will provide opportunity for TheMHS participants to probe the Victorian experience and all the stakeholders’ claims about Safewards.