Quality improvement initiatives to minimize seclusion and restraint

Much literature exists detailing adverse outcomes associated with the use of seclusion and restraint (S&R). Recognizing the negative effects of this intervention, one organization began a quality improvement project to reduce the use of this behavioral management strategy. A retrospective study using the medical record and the S&R database was initiated to examine clinical symptoms at the point of admission of those individuals who later experienced an S&R and to evaluate S&R practices across treatment areas. This initial project identified the admission processes, early treatment initiatives, and individuals experiencing multiple episodes of S&R as critical foci.