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.

The need for occupational therapists continues to rise durin a time when those in health care management must also concern themselves with containing costs. This paper compares the expense of an all therapist department vs. a department comprised of therapists and assistants. Appropriate assignment of therapists vs. assistants in various clinical settings is discussed. The paper also describes how one multiclinic department redefined two assistant positions to enhance productivity.

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Occupational therapists are frequently promoted to management level positions without prior instruction in financial accounting. Accounting information can enhance rational decision making processes at both the middle management and supervisory levels. Although today's literature encourages health care professionals to utilize accounting principles, the occupationd therapy manager is often uncertain as to how to apply these techniques to his own setting. This paper describes how one multiclinic department revised its existing fee structure and utilized the generated data to analyze therapists' productivity and to effect decisions regarding program management.

Occupational therapists are frequently promoted to management level positions without prior instruction in financial accounting. Accounting information can enhance rational decision making processes at both the middle management and supervisory levels. Although today's literature encourages health care professionals to utilize accounting principles, the occupationd therapy manager is often uncertain as to how to apply these techniques to his own setting. This paper describes how one multiclinic department revised its existing fee structure and utilized the generated data to analyze therapists' productivity and to effect decisions regarding program management.