A Multidisciplinary Consultation-Liaison Team Approach to Reduce Enhanced Observer Usage

Area of Science:

• Healthcare Management
• Patient Safety
• Psychiatry

Background:

• Limited evidence supports sitter use for patient safety; it's a costly intervention for disruptive behaviors.
• Current practices often rely on sitters, which are expensive and lack strong evidence for efficacy.

Purpose of the Study:

• To demonstrate how integrating multidisciplinary and psychiatric consultation-liaison (C-L) teams can decrease sitter utilization.
• To improve patient outcomes by implementing nonpharmacologic interventions.

Main Methods:

• A retrospective study detailing the creation and implementation of a multidisciplinary C-L team collaborating with a psychiatric C-L team.
• The multidisciplinary team included advanced practice registered nurses and creative art therapists.
• Developed and monitored criteria for sitter use in conjunction with medical units.

Main Results:

• Sitter use decreased by 72% in the first year of implementation.
• Nonpharmacologic interventions improved patient outcomes through staff education on enhanced observer use.
• Sustained cost reduction of nearly $70K per month over two years.

Conclusions:

• Collaboration between multidisciplinary and psychiatric C-L teams led to significant financial savings and improved patient safety.
• Policy revisions, algorithms, and education were key to reducing reliance on enhanced observers.
• The integrated C-L team approach effectively addressed patient behaviors with nonpharmacologic methods, decreasing sitter needs.