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WILLIAM OSLER HEALTH SYSTEM Restraint Minimization David Koczerginski MD FRCPC Chief of Psychiatry William Osler Health System President AGHPS November.

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Presentation on theme: "WILLIAM OSLER HEALTH SYSTEM Restraint Minimization David Koczerginski MD FRCPC Chief of Psychiatry William Osler Health System President AGHPS November."— Presentation transcript:

1 WILLIAM OSLER HEALTH SYSTEM Restraint Minimization David Koczerginski MD FRCPC Chief of Psychiatry William Osler Health System President AGHPS November 9 th, 2012

2 WILLIAM OSLER HEALTH SYSTEM Jeffrey James Coroner Inquest, September, 2008 All psychiatric and schedule 1 facilities in Ontario should aspire to provide care to clients/consumers/survivors in restraint free environments.

3 WILLIAM OSLER HEALTH SYSTEM Restraint impact on physical health Restraint impact on patient dignity An appropriate focus of change for all schedule 1 facilities in the province of Ontario. Restraint Minimization

4 WILLIAM OSLER HEALTH SYSTEM Restraint Minimization Challenges Balancing safety of patient, community, staff Acutely ill/psychotic/agitated/affectively unstable patients. Frontline duty to detain

5 WILLIAM OSLER HEALTH SYSTEM Restraint Minimization Challenges Inpatient focus on risk assessment, treatment of psychosis, community and patient safety with short length of stay. Facility limitations Staffing limitations

6 WILLIAM OSLER HEALTH SYSTEM Restraint Minimization The Goal Creating an environment that respects patient dignity, ensures staff and patient safety, is respectful of unique multidisciplinary skills and is consistent with the laws of the Province and the realities of clinical practice in acute care hospitals.

7 WILLIAM OSLER HEALTH SYSTEM Restraint Minimization Strategies Culture change through leadership/discussion/process Data collection Education/training programs Optimizing staff and environment

8 WILLIAM OSLER HEALTH SYSTEM Restraint Minimization Strategies Emphasize the interdisciplinary team Define the role of specialized Mental Health RNs Debriefing/reviewing all restraint events

9 WILLIAM OSLER HEALTH SYSTEM Mental Health Least Restraint Policies-reviews and standards? Observation and monitoring? Re-ordering and 2 nd opinions? PRN restraint orders-mechanical and chemical? Data collection and review? Debriefing practices? Education activity/restraint prevention? Discussion


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