Wounds and mental health care: system thinking
| DOI | https://doi.org/10.1108/MHRJ-03-2019-0007 |
| Date | 28 November 2019 |
| Pages | 298-305 |
| Published date | 28 November 2019 |
| Author | Ray Samuriwo,Ben Hannigan |
| Subject Matter | Health & social care,Mental health |
Wounds and mental health care:
system thinking
Ray Samuriwo and Ben Hannigan
Abstract
Purpose –This paper considers how the quality of wound care delivered to people experiencing mental ill
health can be improved at the system level in line with the global focus on improving population health. The
purpose of this paper is to identify how the quality of wound care delivered to mental health care service users
can be improved at a population level through system thinking informed by boundary theory.
Design/methodology/approach –This paper is a critical analysis of practice underpinnedby systems thi nking
and boundary theory.
Findings –Tissue viability care and mental health care have different professional cultures and identities that
are manifest in the way that they are organised and deliver care. If improvements in wound care-related
outcomes at a population level are to be achieved, then it is important that the wound care needs of people
experiencing mental ill health are addressed. Systems thinking and boundary theory provide a useful
conceptual framework for informing quality improvement for people experiencing mental ill health at a
population level. Integrated care plans are a useful mechanism for delivering comprehensive care that brings
about wound healing and recovery from mental ill health.
Social implications –Integrated wound and mental health care plans transcend the professional
boundaries that exist between tissue viability and mental health care services. Improvements in the quality
and safety of care delivered to people with wounds who also utilise mental health services can be achieved
through the use of integrated care plans. Health care policy and organisation need to meet the wound-related
needs of people using mental health services.
Originality/value –There has been a focus on improving many aspects of wound care in line with the global
focus on grand convergence in population health, but there has been very little emphasis on improving the
wound-related outcomes of people that use mental health services. Systems thinking and boundary theory
provide a useful framework for understanding how wound care for people experiencing mental ill health can
be improved at a population level. Integrated care plans are a useful way of ensuring that safe high-quality
wound care is consistently delivered to people experiencing mental ill health.
Keywords Systems, Mental health, Care planning, Boundary theory, Organization and administration,
Wound care
Paper type Conceptual paper
Introduction
The delivery of high-quality care is integral to improving the health of populations and the
sustainable development of nations (Brende and Høie, 2014;United Nations, 2015; Zoghbi et al.,
2014). Patientsafety is a key considerationin any system-level effortsto deliver care that enhances
the health and wellbeing of populations (WHO, 2006). There are international efforts to improve
population health through shared learning and interprofessional team working (Mulley, 2013;
Washington et al., 2016). Theseefforts to reduce mortality andimprove population health areoften
referred to as grand convergence (Boyle et al., 2015; Yamey and Morel, 2016).
Improving population health through grand convergence has been considered in relation to
many aspects of health care including skin health, but is rarely considered in relation to wound
care (Samuriwo, 2018). Despite this, there have been considerable efforts to improve wound
care-related population health through research studies and quality improvement projects. Most
of these research studies and quality improvement projects have focused on improving care
Received 9 March 2019
Revised 12 August 2019
Accepted 17 August 2019
Ray Samuriwo and
Ben Hannigan are both based
at the School of Healthcare
Sciences, College of
Biomedical and Life Sciences,
Cardiff University, Cardiff, UK.
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VOL. 24 NO. 4 2019, pp. 298-305, © Emerald Publishing Limited, ISSN 1361-9322 DOI 10.1108/MHRJ-03-2019-0007
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