title: Impact of a mandatory behavioral consultation on seclusion/restraint utilization in a psychiatric hospital.
abstract: Despite demonstrations of the utility and cost effectiveness of behavioral methods for improving care for people with psychiatric impairments, they are seldom employed effectively in inpatient settings. This study evaluated the impact of an administrative procedure to effect a behavioral consultation for cases of high seclusion/restraint utilization. Seclusion/restraint use for the 53 cases was reviewed for a time period of 6 months before and 6 months after development of a behavioral treatment plan resulting from this procedure. The data revealed a 62% reduction in seclusion/restraint use after development of an approved plan. There was also a reversal in serial trend from increasing use during the months prior to plan development to decreasing use during months after plan development. The procedure is described and implications of the results for clinicians and administrators of psychiatric inpatient programs are discussed.
authors.affiliation: Western State Hospital, Staunton, VA 24401, USA. donatd@cfw.com
authors.forename: D C
authors.initials: DC
authors.lastname: Donat
mesh_terms: D001521:Behavior Therapy; D006739:Hospital Administration; D006753:Hospital Records; D006760:Hospitalization; D006801:Humans; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D010344:Patient Advocacy; D010347:Patient Care Planning / Q000592:standards; D011367:Professional Staff Committees; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012149:Restraint, Physical / Q000379:methods*; D012308:Risk Management; D012934:Social Isolation; D014600:Utilization Review; D014754:Violence / Q000517:prevention & control