2003 Ernest Amory Codman Award Recipient
Organization Award: Behavioral Health Care Award
Millcreek Behavioral Health Services
Magee, Mississippi
For its initiative:
“Sustaining Restraint Reduction Through Culture Change and the Treatment Planning Process”
In 1999, the parent company of Millcreek Behavioral Health Services, Youth and Family Centered Services, Inc., established a corporate-wide goal to reduce restraint use by initiating clinical and cultural change. This change was designed to enhance the safety of the treatment setting, provide a more stable, therapeutic environment, and improve treatment outcomes for its children. The facility emphasized the interdisciplinary treatment plan and a team concept for its staff. Other strategies included staff training in proactive de-escalation techniques; specific monitoring of the process of restraint use; increased physician involvement with children and staff; hiring nurses as residential unit managers; establishing clear policies and procedures for the use of restraint; and establishing a dedicated nurse monitor to oversee the use of each episode of restraint.
Achievements
The results of this initiative:
- Achieved a more than 99 percent reduction in the use of restraints, from 1,025 episodes in 1999 to four episodes in 2003.
- Realized significant improvements in collaborative, interdisciplinary treatment team planning and communication.
- Increased understanding of the patients served.
- Achieved more positive outcomes for the children due to increased physician involvement, care and delivery of services that have facilitated responsiveness to the child's unique individual needs.
- Improved staff and patient interactions due to increased, enhanced training as well as overall efforts to create a safer work environment that fosters continued learning and support.
- Enhanced debriefing process that focuses on staff's reactions to a child's behavior and emphasizes reducing depersonalization and increasing a more positive child focused perspective.
- Achieved positive change in staff turnover and morale.