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progress and benefits, and insights. In parallel, daily improvement
huddles (15-minute long team meetings) were adopted to enable
the team to problem solve other identified improvement work.
The huddles follow a set structure of reviewing work in progress,
new improvement opportunities, work that needs to be escalated
and celebrated. This work was gradually widened to include the
entire team.
Results. The team’s caseload was observed to be continuously
going up from 200 in September 2021 to 264 in October 2022.
We aimed to increase the number of safe discharges and to sus-
tain a steady team caseload. Root cause analysis utilising a fish-
bone diagram identified barriers to discharge, such as lack of
MDT approach and structure to discharge planning. Change
ideas included creation of standard work, describing how an
MDT discharge meeting would work. Actions were agreed to imple-
ment structured weekly MDT discharge meetings where four cases
are discussed and safe discharge plans agreed, sharing responsibility
for discharge decision. This has allowed us to reduce and maintain a
steady caseload with 258 patients in January 2023.
Conclusion. Implementing Our Care Improvement System has
not only provided a structure to our improvement work and
improved our caseload but has also consolidated our team in
working together for a common goal. We have naturally imple-
mented structure to all other team meetings, which have now
become more focused and productive, making our team a more
rewarding place to work.
Abstracts were reviewed by the RCPsych Academic Faculty rather than by the standard
BJPsych Open peer review process and should not be quoted as peer-reviewed by
BJPsych Open in any subsequent publication.
Ecosia: Bringing a Greener Search Engine to the NHS
Dr Amelia Cussans*
Central and North West London NHS Foundation Trust, London,
United Kingdom
*Corresponding author.
doi: 10.1192/bjo.2023.263
Aims. The objective of this project was to switch the default
search engine used on CNWL computers from Google/Bing to
Ecosia. Both Google and Bing have poor ethical and environmen-
tal credentials. Ecosia, in contrast, is a not-for-profit, certified
B-Corporation which funds tree planting and community projects
around the world. Ecosia searches display ads ( just like any other
search engine) however it donates 100% of its profits towards
high-impact agroforestry, tree planting and forest protection.
Methods. ThefirststepwastopitchtheproposaltotheTrust’s
Sustainability Lead. Then, information governance and cyber secur-
ity teams performed assessments and gave clearance. An ICT tech-
nician was allocated the task and they configured the switch for a
pilot group of 38 staff, with the help of step-by-step guides produced
by Ecosia. After a short trial, the pilot group completed a question-
naire. Following satisfactory feedback, the ICT technician switched
the default search engine to Ecosia for the entire Trust staff group.
A Trust-wide email informed staff of the change and provided
opportunity for feedback to be given via an online survey.
Results. A CNWL tree count is sent monthly from Ecosia. Over
the first four months, an estimated 32,872 trees were planted
using the funding generated by CNWL.
The pilot survey showed 80% of participants agreed that
CNWL should use Ecosia as its default search engine (0% =
should not; 20% = undecided). 62% felt Ecosia performed the
same as the previous search engine (14% = much better; 5% =
somewhat better; 20% =somewhat worse; 0% = much worse). 86%
said they would use Ecosia on their personal devices. Further
comments included:“"This is a great initiative from the trust,
who in many realms benefit private profit enterprises to the detri-
ment of our planet.”;“"As a Trust, in addition to using Ecosia, we
should look for other similar measures, on the grounds that every
step towards sustainability makes a cumulative impact”";“Google
performs better than Ecosia”. It is noted that if an Ecosia search
does not yield the required results, it can easily be switched to
Google by clicking ‘More’—>‘Google’.
Conclusion. Switching to Ecosia is an achievable action that
health organisations can take. Collectively we can fund the
protection and regeneration of forests, which benefits people
and the planet, and engages staff in climate action. The next
step is for other Trusts to switch, with an ultimate goal of all
NHS organisations using Ecosia.
Abstracts were reviewed by the RCPsych Academic Faculty rather than by the standard
BJPsych Open peer review process and should not be quoted as peer-reviewed by
BJPsych Open in any subsequent publication.
Developing a National Strategy for Child and
Adolescent Mental Health in Palestine
Dr Nadia Dabbagh1*, Dr Samah Jaber2, Ms Agnes Raboczki1,
Ms Enas Tina3and Professor Mohammed Al-Uzri4
1
Royal College of Psychiatrists, United Kingdom, Dubai,
United Arab Emirates;
2
Ministry of Health, Ramallah, Palestine;
3
Medical Aid for Palestinians (MAP), Ramallah, Palestine and
4
Royal
College of Psychiatrists, UK, Leicester, United Kingdom
*Corresponding author.
doi: 10.1192/bjo.2023.264
Aims. The Royal College of Psychiatrists, UK, is the professional
body responsible for education and training, and setting and rais-
ing standards in psychiatry. It is an increasingly international
organisation with approximately a fifth of members living outside
the UK. In partnership with the UK-charity Medical Aid for
Palestinians (MAP), the college was invited to develop a national
strategy for child and adolescent mental health in Palestine for the
Ministry of Health. Children are at higher risk of developing men-
tal illness when living in overcrowded areas with ongoing shelling,
siege, and other acts of violence as is the case in Gaza. A signifi-
cant proportion of Palestinian children experience serious psy-
chological distress especially anxiety and post-traumatic stress
disorder (PTSD), with children reporting not wanting to be
apart from their parents. The aim of the strategy is to set key pri-
orities for child and adolescent mental health so that funders,
institutions, organizations and community members align their
activities in a coordinated and efficient way.
Methods. Information was gathered from an extensive literature
review and three in-person missions to visit the West Bank
to meet key stakeholders from governmental and non-
governemental organizations including the Ministries of Health,
Education and Social Development and the only Child and
Adolescent Mental Health Services in Halhoul, north of
Hebron. A thematic meeting was held in August 2022 and a feed-
back meeting in December 2022. All comments and feedback
were reviewed and incorporated into the final document for sub-
mission to the Ministry of Health for official approval.
Results. Today’s child in Palestine bears the burden of decades of
violence, conflict and hardships that have accumulated during
their lives and those of their parents and grandparents. In total,
2242 Palestinian children have been killed by Israeli military
S84 Poster Presentations
https://doi.org/10.1192/bjo.2023.263 Published online by Cambridge University Press