Background
Methods
Participant selection and setting
Data generation
Patient and public involvement
Analysis
Results
Participant characteristics
Characteristics | Patient N (%) | Staff N (%) |
Gender | ||
Male | 12 (100%) | 6 (50%) |
Female | 0 | 3 (25%) |
Prefer not to say | 0 | 3 (25%) |
Ethnicity | ||
White-British | 4 (33%) | 4 (33%) |
Asian-British | 0 | 2 (17%) |
Black or Black British - Caribbean | 2 (1%) | 0 |
Black or Black British – African | 2 (17%) | 1 (1%) |
Black or Black British - British | 1 (1%) | 0 |
Black or Black British – Other/Unspecified | 2 (2%) | 0 |
White - Irish | 1 (1%) | 1 (1%) |
Prefer not to say | 0 | 3 (25%) |
Ward level dependency | ||
Assertive Rehabilitation | 10 (83%) | 1 (1%) |
Increased support and assertive treatment | 2 (17%) | 2 (17%) |
Admissions | 0 | 5 (42%) |
Not available | 0 | 3 (25%) |
Primary diagnosis | ||
Paranoid schizophrenia | 5 (42%) | N/A |
Bipolar affective disorder | 2 (17%) | N/A |
Emotionally unstable personality disorder | 2 (17%) | N/A |
Schizotypal disorder | 1 (1%) | N/A |
Paranoid personality disorder | 1 (1%) | N/A |
Mental and behavioural disorders due to multiple drug use and substance misuse | 1 (1%) | N/A |
Role | ||
Healthcare facilitator | N/A | 6 (50%) |
Ward doctor | N/A | 2 (17%) |
Nurse | N/A | 1 (1%) |
Consultant psychiatrist | N/A | 1 (1%) |
Senior clinical manager | N/A | 1 (1%) |
Clinical nurse manager | N/A | 1 (1%) |
Previous use of Oxehealth before | ||
Yes | N/A | 2 (17%) |
No | N/A | 10 (83%) |
Patient mean (SD) | Staff mean (SD) | |
Length of stay (days) | 1052.8 (701.2) | N/A |
Length of service at Broadmoor Hospital (years) | N/A | 9.3 (11.1) |
Length of career in mental health (years) | N/A | 11.8 (11.6) |
Main themes
Detecting deterioration and improving health and safety
“I think it’s actually really important that Broadmoor, and especially because of the complex nature of the patients and the treatment-resistant patients, how aggressive and unwell patients are and it’s a lot more difficult to take physical health, vital signs monitoring at Broadmoor, so I think it’s completely appropriate here, but it needs to be explained properly to patients and staff.” (Staff 11)
“Well going back to that… I remember that night the alarm bell went off so I’m not sure whether that was something that Oxehealth triggered or whether that was part of the plan of Oxehealth to raise the alarm by setting off the alarm bell I’m not sure if that’s part of the plan obviously I’m not privy to what happened... but somebody died so…was it successful or did it not work but somebody died at the end of the day so if it’s there to prevent death and somebody dies then that means it failed.” (Patient 7)
“A patient died in their room where Oxehealth was, and I think it actually provided some timelines closer to the time when the patient is suspected to have passed away rather than…and it ruled out any assumptions that what happened what went wrong” (Staff 4, Nurse)
“I think he died in the area where there is a blind spot, rest in peace. So maybe if the Oxehealth could have a way of monitoring that blind spot if it was possible a bit better than it actually can or does and then that allows staff then to react, which could then save a patient’s life, react quicker maybe which could then save a patient’s life. Because I think that by the time they was made aware of him not being where he should be the time had really gone by and it was too late.” (Patient 42)
“Big brother syndrome”
“It’s not a substitute to doing the general observation or the eyesight observations and stuff like, it’s an additional technology that you can use to help you to assure yourself that the patient is physically well” (Staff 4, Senior Clinical Manager)
“I’ll wake up sometimes, they shine it in your eyes so you wake up, like if your watching TV and they’re disturbing you all the time shining it in” (Patient 117)
“I still feel alright, but now I know. At first, I said to my friend, they don’t see me in my room. They can’t see me. Now I know that they can see me, sometimes I pray, and these are private things, they might have seen me pray a couple of times maybe” (Patient, 93)
“It’s the cameras in it, it’s all watching somebody. Like I always get changed in my bathroom and I always make sure I’m not in my room, I’m quite conscious about that.” (Patient 117)
“We need not to forget that our patients have a mental illness, and again, some of these paranoias and suspicions relate to being watched, you know” (Staff 4, Nurse)
Privacy and dignity
“…the other day with another patient on another ward… he didn’t like it [Oxehealth] at all, he thought… his dignity was getting invaded and his privacy was getting invaded and I’ve heard a lot of other patients like when I was on [ward name] I heard other patients saying they didn’t like it in the room and it’s not fair they are being watched on cameras and that so I’ve had a lot of negative response from it.” (Patient 117)
“Er, if they see you naked, they apologise but that’s not really maintaining privacy is it.” (Patient 2)
“It’s all about reassurance and information. When we build that trust up and they start to trust us a bit more, but that comes with time and then, you know, they accept more of the reassurance about it” (Staff 2, Nurse)
“There are a few points in terms of ethics in terms of the continuous recording, as well as patient privacy and also who has access to that information because I guess we are sharing information” (Staff 8, Healthcare facilitator)
Knowledge and understanding
“I don’t know. I think it’s something to do with lasers” (Patient 93)
“Not really, no one’s really explained to me how it works I learnt just myself by talking to some patients and that.” (Patient 117)
“it’s quite reassuring for me as a junior doctor to know that people’s heart rate is not elevated, especially if you’re worried about some infection. Or that their respiratory rates particularly high, if you’re worried about breathlessness or anything like that. So, I think it’s very helpful and reassuring from that point of view.” (Staff 11, Ward Doctor)
Acceptance (patient only)
“…I don’t mind it, it don’t bother me I don’t really think about it, it don’t come into my thoughts…it’s just there, part of my room.” (Patient 117)
“Well if I thought it was going to save people’s lives I would want it but if it was just for surveillance then I would say take it away, everyone has a right to their privacy. You know.” (Patient 22)
Barriers to use and practical issues (staff only)
“Lack of understanding of it like me! Perhaps there might be a lack of trust in it compared to like the more familiar traditional ways of measuring the outcomes.” (Staff 2, Consultant Psychiatrist)
Future changes needed
“Sometimes it doesn’t always pick up readings, even when people are still. And I’ve noticed that myself when I’ve tried to check it.” (Staff 11, Ward doctor)
“There should be more sensors in the room, you know like, Oxehealth technology will only get better over the years but they should be one of the bathrooms” (Patient 60)