Paying bills, keeping in touch with friends, trying out a new hairstyle, watching politicians make idiots of themselves, listening to Lady Gaga’s new album, learning about our health…. How did we manage before the Internet?!
Internet access can change even the most resource-deprived wards into information-rich environments. Nowadays being computer-savvy is becoming an increasingly important life skill. The internet gives patients the ability to connect with friends and family around the world via email, chat rooms and social media. This helps them maintain important links and relationships at a very difficult time in their life.
As Gloucestershire Partnership NHS Foundation Trust put it:
“The Internet is an electronic highway connecting hundreds and thousands of computers and millions of individual users all over the world. Computer technology has the capacity to assist the therapeutic programme for the patients principally through its use to engage people in self care (eg care of financial matters), leisure (games, digital photography), work (education and recreation programmes)”.
The long list of creative ways in which wards are enabling patients to have Internet access illustrates the change over the last few years from widespread concern about introducing the Internet to a consensus that it is essential on most wards. Implementing this commitment has been a bit of a slog for most wards, with tedious difficulties from BT and enough red tape to gift-wrap the hospital many times over. We salute the tenacity of ward staff who have heroically gritted their teeth and kept going til the first patient sends off their first email! And we’re very grateful to pioneers such as Croydon and Gloucester for generously sharing their protocols and guidelines with other wards.
The use of the Internet on mental health wards pretty much reflects its (legal….) use in family homes:
Communication: eg email, Skype
Social Networking: eg Facebook, Google+, Twitter, chat-rooms, forums, blogs, comments
Information: eg Google, Wikipedia, NHS Choices and other trusted health websites
Learning: Online CBT course, Open University
Banking and finance: eg paying bills, checking mobile phone account, managing bank account
Shopping: eg ebay, Amazon, Play.com
Entertainment: eg youtube, BBC iplayer
Work: selling online, job-hunting
- Provide service users with their own memory stick or disc. The team can then download specific requested information and place on the service users memory stick or disc for them to access via the computer suite.
- Each ward has a lap-top and broadband, and the hospital has wi-fi, which is ideally flexible, and by definition wire-free. In addition to all the usual stuff done by patients on the Internet, staff also help with downloading music to their MP3 players.
- Liaising with IT department to see whether there are decommissioned computers that patients could use on the wards possibly initially for games and word processing etc
- Through local IT outreach scheme, a computer whiz came into the ward with 8 lap-tops + printer. As well as learning how to use computers, patients were able to design and print their own Xmas cards
- Computer room – only complaints are about slowness of broadband and desire for 2nd PC!
- The art room provides Internet access, which was a huge performance to set up. They were given conflicting advice about how to secure Trust approval and finally discovered there’s an application form. It involved lots of follow-up phone calls to fix up computers, broadband, phone line, router etc. But it was worth it! They run an Internet Café once a week, with tea, cakes and Internet access; the OT tech runs it, and patients can also use it in timed slots during the week. Nurses are supporting and monitoring it eg to prevent manic spending. They’ve developed an Internet policy, based on preparation done by the OT.
- Computers and internet access, eg for patients having access to their bank accounts etc.
- The cafe area “The Oasis” includes an internet cafe style. The second terminal in the reception area is used as an information ‘what’s on’ type resource.
- The wards have internet access and service users access the internet for specific queries with staff.
- Currently all the inpatient wards have a standard computer that is available for service user use.
- Regular ward-based computer groups/sessions are made available throughout the week as part of the therapeutic program.
- Both wards within the hospital have ‘Internet Café’s’ where patients have their own password to access the internet.
- There is an internet café in each unit.
- Both wards within the hospital have ‘Internet Café’s’ where patients have their own password to access the internet.
Some service users have also chosen to bring their own Lap Tops/ Mobile Phone onto the Unit so they can have Internet Access via a dongle.
Training and Education
- Information Technology ‘taster’ sessions on the unit in partnership with the local college
- Linking with local college’s e-learning scheme, which uses the exciting art of mobile technology to improve english, maths and basic IT skills through mobile phones, pocket computers and the internet.
- The local FE college come in to interview patients and enrol those who want to join. And when ex-patients start at college, they feel less thrown in the deep end because they have had a foundation in hospital.
- The Learning Resource Centre, in a building adjacent to the hospital, was grant funded with British Telecom a number of years ago for service user and staff usage. The centre is equipped with about 12 terminals and is linked with the local further education college and is staffed by the Trust. It teaches patients all things to do with computers ranging from basic to advance course. Service users use IT on an individual basis and Occupational Therapy have set sessions there on a weekly basis.
- Some patients use internet to research their medication. Booking system for PC, sorted out at breakfast meeting.
- Local Mind group has Wireless Outreach Network. Patients in acute wards can get computer training through three sets of wireless laptops. The Internet is mostly used for communication, patients’ own research (including into their illness, its management and treatment), finding a ‘stimulus’ e.g. a walk through the virtual Tate gallery, exploring a hobby, even setting up a learner’s mobile phone! The recovery courses focus on using Word as a medium for CVs, letter writing etc. The qualified tutor and learning support assistant take in digital cameras and then show learners how to e-mail pics taken to friends and family, and even how to design Powerpoint presentations. Some learners take their newly found Internet skills into the local libraries after they leave hospital.
- Fabulous computer room with an expert member of staff supporting patients to do incredible things with the equipment. Some patients can use PCs and want to expand their computer literacy. A brilliant thing is that patients can use their photos to create personalized gifts such as plastic photo coasters, keyrings and magnets.
- Services users stated that they would use the internet for a number of reasons including; Email and other communication mediums, CV writing , work processing, internet information searching, digital photo editing and e-learning.
- Patients look up events, classes, courses and other local facilities. This plays an important part in their discharge planning community plans.
- Access to the internet should be risk assessed for each individual. Some individuals may not need supervision, others will however need to be supervised initially by a member of staff; this may be intermittently or constant in order to support an individual to use the internet effectively.
- Service users are made aware that they should never share personal information (name, address, telephone, or credit card number) online. Buying items on the internet should be closely supervised.
- Service Users are responsible for good use of the Internet just as they are within the ward environment.
- Got round the problem about Trust anxiety about patients hacking into the network by… having a stand-alone, unnetworked PC! How simple is that?? And they got round the phoneline (or lack thereof) problem by using wireless connections.
- Clear guidelines are set in order to ensure safety when using the internet and that access is not abused.
- A member of staff is allocated on each ward who is sufficiently trained in the use of computers and the internet in order to offer guidance, support, teaching and monitoring of the use.
The Internet is a very interactive communications medium. The Internet gives them the ability to connect to friends and family around the globe. Communication through email or various chat programs can be almost instantaneous, ensuring that while they are in hospital they can maintain social links that are important to them.Engage in the community
– the internet will offer service users to explore what is available in their local community. They can look up events, classes, courses and other facilities that may be available to them after discharge. Service users access to local resources may play an important part in their own discharge planning community plans.
Up to date and wide resources
– Internet access changes even the most resource poor therapeutic rooms into information rich environments. It provides therapeutic rooms with rich resources for learning.
– Service Users can decide which sites they will visit and which links they will follow. By design, the structure of a web site encourages visitors to delve deeper and deeper into the site, allowing them to navigate through the information at their own pace. Links on one web site often lead the user to other web sites containing even more data.
– There are wide range of software that we can use with individuals to help them learn and develop, for example; word processing skills, languages, math’s, graphical editing programs.
– 1:1 sessions will be provided in order to teach and guide service users to develop their work processing skills. They may type up the minutes from the ward community meeting, prepare an up to date CV in preparation for work.
Policy For Access To The Internet
To gain access to the Internet within the hospital, patients must have had the Internet policy explained to them by the designated personnel (see below) and then complete an “Internet Access Form”.
2. Patients must then sign the Internet Access Form showing agreement to abide by the policy guidelines. For adolescents (ie under 18’s), the parent/guardian’s signature will also be required.
3. Any patient using a computer will be under constant 1:1 supervision from the designated personnel. They will be the only members of staff to know the password to gain access to the equipment.
4. The computers available for use by patients are currently in The Media Room at the Therapy Department.
5. The following uses of Internet access are not permitted:
a. To access, upload, download or distribute, obscene or sexually explicit material.
b. To access, upload, download or distribute material which is of a racist or political nature or which incites violence, hatred or any other illegal activity.
c. To transmit obscene, abusive or sexually explicit language.
d. To vandalise, damage, disable or access other person’s files or work without permission.
e. Accessing chat rooms, gambling sites, shopping (including holiday sites) e-banking/financial sites.
6. Finally, the use of the Internet is to be accessed by patients in a responsible manner. Inappropriate use will result in the cancellation of the availability for individuals concerned in order to support their safety and those of others.
When supervising Internet access, staff will deem what is appropriate and their decision will be final.
Ensuring safe and legal Internet access – access to certain sites will be blocked, but staff should monitor the use of the Internet and if they are concerned about any site that is being accessed they should request that the individual logs off that site. If the patient refuses their use of the Internet will be terminated for that session, and the team can decide if any future sanctions will be necessary. The site in question should then be blocked by staff and other wards can be advised that this action has been taken so they can also block the site. An incident report should be completed to enable overall monitoring of any unsafe and illegal Internet use.
Any violations of Internet use should be dealt with on an individual basis. If staff become aware that patients are accessing material that could be considered offensive or detrimental (please see below), are attempting to obtain details about a member of staff relating to their personal life, are sending nuisance e-mails or are in any other way using the Internet to hassle or abuse others immediate action must be taken to stop this. A patient risk assessment must be updated with information regarding any use of the Internet that would constitute a risk. Staff must use their knowledge of the individual patient, taking into account that patient’s clinical state and needs to decide what action is best.
Internet Access Form
Excerpt from 2gether Foundation Trust
For Completion by Patient
Before having internet access available to you, you will need to meet with an Occupational Therapist who will explain the Internet Access Policy to you. You will need to sign below to state that you understand the policy and agree to abide by the hospital rules.
|I agree to …..||
Signed with initial
|Allow staff to supervise me whilst I access the internet|
|Maintain both my own and other individuals confidentiality at all times|
|Not to access any internet site containing material of sexually explicit, racist or offensive nature|
|Not access sites dedicated to any form of gambling|
|Not use this resource for the purposes of personal shopping|
|Not consume food or drink whilst at the work station|
|Have my opportunity to use the internet reviewed should I break the rules above|
I have met with an Occupational Therapist and they have explained the Internet Access Policy to me. I agree to the terms and conditions set out in the policy and agree to abide by them.
Name (please print)……………………………………………………………………..
Signed ……………………………………………. Date ………………………
Free internet cafe opens at Royal Bolton Hospital
THE country’s first free internet cafe in a mental health ward has opened in Bolton.
It was set up after requests from patients and carers, who wanted to stay in touch with family and friends, access information about medications and mental health problems and exchange information on support groups and forums.
Karen Hodgetts, assistant director for Inpatients and Crisis Mental Health Services at GMW’s Bolton Mental Health Directorate, said: “There are so many good websites for people with mental health problems and we recognise the value of our patients and their carers having access to this information, so they can create awareness of mental health issues, join discussions, and share their feelings. “Using computers with internet access is a great way for people to feel more socially included. It helps people to feel connected to their daily routine and will be something that complements our existing treatments to support people with mental health problems in their recovery.”
Greater Manchester West Mental Health NHS Foundation Trust (GMW) funded the cafe, which will be run by BAND — a voluntary mental health organisation and charity set-up to support people in Bolton who live with mental health problems.
It is open three afternoons a week, every Tuesday, Wednesday and Thursday, in the Rivington Unit at Royal Bolton Hospital.
There are four computers available and there will be opportunities for patients to complete workshops run by hospital volunteers, on computer skills, online financial management, creative writing, safe web usage, operating Windows and using music software. The cafe was officially opened by Mike Chapman, vice chairman of GMW, Martin Hadfield, community engagement and representation coordinator from BAND, Karen Hodgetts, assistant director for Inpatients at GMW’s Bolton Mental Health Directorate, and Hospital Volunteers from BAND.
Martin Hadfield, community engagement and representation coordinator for BAND, said: “The new internet cafe will function alongside our hospital volunteer scheme by providing an environment that is inclusive, stimulating, friendly and supportive.”
- I used the ward computer to find out as much as possible about my diagnosis. The staff were really helpful by giving me a list of sites to go to.
- I was so worried that I wouldn’t be able to pay my rent whilst I was on the ward but the staff helped show me about internet banking and now I can pay all my bills even when I’m not well.
- I use the internet to manage my bills and finances.
From: The Mental Health Act Commission – Thirteenth Biennial Report 2007–2009
– From Health Service Journal, June 2011
BT helps the NHS cut costs while improving patient care.
NHS organisations across the country face similar challenges: how can they deliver efficiencies and increase productivity while still ensuring that patients receive the best possible care and how do they increase quality and clinical outcomes when there is so much pressure on resources?
One of the answers to these questions is through the innovative use of IT and communications. »
As a long-term partner to the NHS, BT is committed to helping the health service transform patient care and meet the challenges of an ever-changing world.
We’ve identified four key areas where our networked IT solutions and know-how can help.
Improving organisational efficiency -or in other words using IT to increase productivity and deliver real savings.
Our expertise in providing unified communications – integrating voice and data networks in addition to providing mobile communications and flexible working services – is helping NHS trusts provide more effective and efficient healthcare. We are already helping organisations like Worcestershire Health Community to track vital equipment such as defibrillators and intravenous pumps using radio frequency identification technology. This means they can pinpoint exactly where the equipment is saving staff valuable time.
Increasing the productivity of your people – allowing them to spend more time with patients. Our Mobile Health Worker solution – which allows community staff access to patient records on the move -has been a revelation for Kirklees Community Health Services. It has already saved £600,000 a year in travel costs alone and it’s anticipated that total savings will reach £10m a year. In NHS Lanarkshire, flexible working has allowed staff to increase the amount of time they spend with patients by a fifth.
Connecting care – making the most of the investment already made in the NHS. In recent years, the NHS has created the core infrastructure needed for a modern, efficient service. Central informatics and clinical information systems run over a secure nationwide broadband network.
With this infrastructure in place, now is the time to use this as a platform for innovation.
For instance, the West London Cancer Network saves 5,500 hours of consultant time and 10,000 plus hours of general staff time by using N3 videoconferencing for regular meetings. While every day, our technology enables 35,000 online hospital bookings and 700,000 prescriptions to be sent electronically.
Delivering a better patient experience -by using the technology available to bring people together. For instance, we are working with NHS Wakefield District to allow patients suffering from chronic heart failure to be monitored from the comfort of their own homes. Using built-in videoconferencing, patients and carers are able to communicate without unnecessary hospital visits. This same technology is also transforming the way people manage and control long-term conditions, minimising GP and hospital visits.
From self-service check-ins to new ways of accessing information at the bedside, IT can make a real difference to a patient’s experience of the NHS.
Wherever you look, technology is having a profound effect on the NHS. By improving operational efficiency, increasing productivity and making the most of the investment made so far – IT can cut costs and improve patient care.
Resources and references
Uses Of The Computer And The Internet On The Croydon Wards
Wotton Lawn Hospital – Internet Access Policy
Free internet cafe opens at Royal Bolton Hospital
Access to computers and the internet
The Mental Health Act Commission – Thirteenth Biennial Report 2007–2009
INNOVATION, NOW – From Health Service Journal, June 2011
Buddy runs the show…