Restraint reduction has been in the news a lot here in the UK. While we obviously do train people in restraint techniques, our focus has always been on prevention, with use of safe, non-harmful physical intervention only as a last resort.
As our CEO has referenced
before on this topic, it is clear that six core strategies can significantly reduce the use of restraint and other coercive interventions. While variations are available, including the work produced by Ontario Shores Hospital (Canada); the Checklist for Restraint Reduction (David Colton, 2010); and the Australian National Mental Health Consumer and Carer Forum ‘Ending Seclusion and Restraint’ (2010), the key restraint reduction strategies that can be drawn from this information are:
Strategy One: Leadership
The organisation develops a mission, philosophy and guiding values which promote non-coercion and the avoidance of restraint. Executive leaders commit to developing a restraint reduction plan which is implemented and measured for continuous improvement.
Strategy Two: Performance Measurement
The organisation takes a ‘systems’ approach and identifies performance measures which determine the effectiveness of its restraint reduction plan and which measure key outcomes for customers.
Strategy Three: Learning and Development
The organisation develops its staff with the knowledge and skills to understand and prevent crisis behaviour. Training is provided which gives staff the key competencies and supports the view that restraint is used as a last resort to manage risk behaviour associated with aggression, violence and acute behavioural disturbance.
Strategy Four: Providing Personalised Support
The organisation uses restraint reduction tools which inform staff and shape personalised care and support to customers.
Strategy Five: Communication and Customer Focus
The organisation fully involves customers in a variety of roles within the service, identifies the needs of customers and uses these to inform service provision and development.
Strategy Six: Continuous Improvement
The principle of post-incident support and learning is embedded into organisational culture.
Or, to say it simply, Care, Welfare, Safety, and Security
℠ for all.
How does your organisation approach restraint reduction?