Executive-Level Reviews of Seclusion and Restraint Promote Interdisciplinary Collaboration and Innovation

Abstract

Elimination of seclusion and restraint requires support at all levels of an organization, especially from leaders who visibly champion and communicate their vision. Nurses, physicians, educators, and administrators at New Hampshire Hospital, an acute psychiatric inpatient facility, have established a standard meeting time and place for an executive-level review of every episode of seclusion and restraint. The standing meeting demonstrates the organization's commitment to caring for both patients and staff. The daily meetings foster a spirit of interdisciplinary collaboration, where direct care staff have the opportunity to tell their stories and share their ideas and concerns in an environment that is caring, supportive, and devoid of criticism or blame. Narrative descriptions of emergency interventions, including what was learned from debriefings with patients and staff involved, provide data about factors that may contribute to the use of seclusion or restraint. This forum provides visible administrative and clinical support that promotes creative thinking, collaborative problem solving, and the exploration of new ideas recommended by those directly involved in providing patient care. It has fostered exploration and development of strategies that have minimized episodes of aggressive behavior as well as seclusion and restraint.

A Concept Analysis of Interdisciplinary Collaboration in Mental Healthcare

“…Through IDC, team members perceive that their effort is recognized and their opinions are valued [19]. IDC also enhances communication among health care staff, clients and clients' family, which boosts the teamwork [25].…”

“…Leadership establishes the foundation of IDC, with continuous teamwork towards common goals [18][19][20][21][22][23]. Shared leadership is conducive to IDC: Assigned respective leadership responsibilities, different disciplines can jointly implement practices and institute changes through negotiation, rather than simply following 'orders' as in the conventional model [23].…”

“…The most common attribute of IDC in the context of mental healthcare was communication [17][18][19][20][21][22][23]. Open communication facilitates shared understanding which can ensure each discipline's perspectives are regarded, for the clients' benefits [20].…”

Untitled

“…Share goal is an attribute that can foster IDC [17][18][19][20][21][22][23][24][25][26][27][28][29][30]. Shared goal can drive the whole team to make endeavours for a common goal that cannot be reached when individuals work on their own [17].…”

“…Improved quality of care and patient outcome IDC improves quality of patient care and patient outcomes [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. IDC exploits the full potientialof different disciplines, resulting in clinical improvement which better benefits the clients [32][33][34].…”