title: Reducing violence in a child psychiatric hospital through planned organizational change.
abstract: OBJECTIVE
  A successful attempt to reduce aggressive behaviors and counter aggressive staff interventions, including seclusion and restraint, in a child psychiatric hospital.
  
  
  OBJECTIVE
  To offer a model for reducing violence within child psychiatric facilities.
  
  
  METHODS
  The agency in which this project was carried out was a 50-place public child psychiatric hospital affiliated with an urban university. Discussion includes the strategies utilized including utilization of practice-based research, assessment of the level of aggression within the agency, change in staff perception about the use of coercive interventions to manage behavior, revision of the behavior management program and of policies relating to crisis events, and increased involvement of families.
  
  
  CONCLUSIONS
  This experience in reducing aggression within the hospital validates theory that suggests that violence within institutions is context-based, involving patients, staff, and the institutional climate. The authors believe that the outcomes support the proposition that the use of coercion is determined more by traditions of practice and the mindset of the staff than by clinical necessity, and that its use can be significantly reduced by organization interventions.
authors.forename: S
authors.initials: S
authors.lastname: Goren
authors.forename: I
authors.initials: I
authors.lastname: Abraham
authors.forename: N
authors.initials: N
authors.lastname: Doyle
mesh_terms: D000293:Adolescent; D001521:Behavior Therapy; D002648:Child; D002665:Child Psychiatry; D005260:Female; D006776:Hospitals, Pediatric; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration*; D009936:Organizational Innovation; D011568:Psychiatric Nursing / Q000193:education / Q000458:organization & administration*; D014754:Violence