title: Reducing mechanical restraints in acute psychiatric care settings using rapid response teams.
abstract: This article describes the use of rapid response teams to reduce the use of mechanical restraints (i.e., restricting a person's movement through the use of a mechanical device such as a backboard, net, or papoose) in an acute psychiatric care setting. Rapid response teams have proven highly effective for emergent medical patients, but have not typically been used in behavioral health care settings. Utilizing a rapid cycle process improvement approach, a response team was convened following each episode of mechanical restraint in an inpatient psychiatric treatment facility. Initial results, during a 6-week rapid cycle change process, showed that mechanical restraints were reduced by 36.4% when compared with a 6-week baseline and when compared with a 1-year baseline. Changes in hospital census during the implementation process did not appear to account for the reduction in restraints. Rapid response teams and rapid cycle process improvement are discussed as useful change vehicles for behavioral health care organizations.
authors.affiliation: Acadia Hospital, 268 Stillwater Avenue, PO Box 422, Bangor, ME 04402-0422, USA. dprescott@emh.org
authors.forename: David L
authors.initials: DL
authors.lastname: Prescott
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Madden
authors.forename: Marilyn
authors.initials: M
authors.lastname: Dennis
authors.forename: Paul
authors.initials: P
authors.lastname: Tisher
authors.forename: Carrie
authors.initials: C
authors.lastname: Wingate
mesh_terms: D006778:Hospitals, Psychiatric / Q000458:organization & administration*; D006801:Humans; D008281:Maine; D019982:Organizational Case Studies; D010348:Patient Care Team; D012149:Restraint, Physical / Q000706:statistics & numerical data*; D013997:Time Factors; D017749:Total Quality Management / Q000379:methods*