A crisis management quality improvement initiative in a children's psychiatric hospital: design, implementation, and outcome.
Behavioral crisis management, including the use of seclusion and restraint, is the most high risk process in the psychiatric care of children and adolescents. The authors describe hospital-wide programmatic changes implemented at a children's psychiatric hospital that aimed to improve the quality of crisis management services. Pre/post quantitative and qualitative data suggest reduced restraint and seclusion use, reduced patient and staff injury related to crisis management, and increased patient satisfaction during the post-program period. Factors deemed beneficial in program implementation are discussed.
Bradley Hospital, East Providence, RI 02915, USA. mpaccione@lifespan.org
Margaret R
MR
Paccione-Dyszlewski
Christine A
CA
Conelea
Walter C
WC
Heisler
Jodie C
JC
Vilardi
Henry T
HT
Sachs
D000293:Adolescent; D032763:Behavior Control; D002648:Child; D003419:Crisis Intervention / Q000458:organization & administration*; D006778:Hospitals, Psychiatric; D006801:Humans; D007318:Inservice Training; D001523:Mental Disorders / Q000628:therapy*; D061214:Patient Safety; D017060:Patient Satisfaction; D016730:Program Development; D058996:Quality Improvement; D014481:United States; D014947:Wounds and Injuries / Q000517:prevention & control