title: [Could you please reduce your seclusion rates? To structure patient care by the methodical work approach].
abstract: BACKGROUND
  Creating a safe treatment environment with a minimum use of seclusion at a ward for intensive psychiatric care is a complex process involving many actors. Although s/he is accountable for the use of seclusion, the psychiatrist's influence on actual seclusion practices is limited. The methodical work approach (MWA) to patient care is designed to improve multidisciplinary care delivery.
  
  
  OBJECTIVE
  To investigate ways in which the psychiatrist can structure the treatment and reduce seclusion rates by introducing the MWA.
  
  
  METHODS
  We performed a quantitative analysis of the effects that the implementation of the MWA on an intervention ward had on the use of seclusion, comparing the intervention ward to control wards. We also conducted a qualitative analysis of the changes that occurred in the work process and in the roles of the various professionals involved.
  
  
  RESULTS
  The use of seclusion had reduced significantly more at the intervention ward than it had at the control wards. The reduced seclusion rates were associated with an increase in interdisciplinary collaboration and professionalisation.
  
  
  CONCLUSIONS
  By helping to limit the use of seclusion, possibly due to enhanced interdisciplinary collaboration and professionalisation, the MWA offers new horizons for mental health care professionals and their patients.
authors.forename: C E
authors.initials: CE
authors.lastname: Boumans
authors.forename: J I M
authors.initials: JI
authors.lastname: Egger
authors.forename: G J M
authors.initials: GJ
authors.lastname: Hutschemaekers
mesh_terms: D016022:Case-Control Studies; D006801:Humans; D033183:Interdisciplinary Communication; D009426:Netherlands; D010347:Patient Care Planning; D010348:Patient Care Team; D010356:Patient Isolation / Q000523:psychology* / Q000706:statistics & numerical data*; D011618:Psychotic Disorders / Q000523:psychology; D058996:Quality Improvement