Restraint Reduction in Behavioral Health Care
By Amanda Jepson | Categories: | Comments Off on Restraint Reduction in Behavioral Health Care
Temple University Health System leaders in 2021 identified the need to minimize restraint use in behavioral health. The health system launched a targeted performance improvement initiative to enhance patient and employee safety, specifically focusing on mitigating patient re-traumatization. This initiative aims to instill positive change during hospitalization by eliminating the use of mechanical restraints in the inpatient behavioral health setting, leading to positive impacts on the larger community as patients transition back into neighborhood-based living environments.
Interventions included a revamped de-escalation curriculum equipping staff with updated techniques to mitigate patient distress proactively. Staff members received education on the importance of individualized verbal de-escalation techniques, focusing on each patient’s strengths, triggers and coping mechanisms outlined in their treatment plans. Enhanced toolkits with 1:1 therapeutic processing and behavior planning help support patients that may require additional clinical support during the course of their inpatient psychiatric treatment. Additionally, the health system restructured emergency response reporting protocols to emphasize real-time data collection, enabling rapid escalation response and promoting transparency in restraint reduction efforts. To promote staff morale about maintaining a safe, restraint-free environment, leadership launched a communication campaign highlighting “days – restraint free,” providing staff with a benchmark to celebrate progress.
Temple created a restraint reduction subcommittee composed of essential frontline staff members, clinical departments, physicians, and nurses. This interdisciplinary involvement cultivates a sense of ownership and commitment to the project’s goals. During program development, the health system prioritized staff and patient feedback to ensure intervention techniques were effective. As the program has progressed, leadership have maintained an open feedback loop with staff, contributing to a safer and supportive environment for patients and employees.
When the program began in 2022, the restraint rate at Temple University Health System was 9.45 per 1,000 patient days. By the end of fiscal year (FY) 2024, the rate dropped to 0.065 per 1,000 patient days. In FY 2025, restraint incidents are estimated to decrease by 94 percent from FY 2021: 21 incidents compared with 345 incidents. This effort has improved overall health outcomes and promoted health equity by creating safer, more therapeutic patient environments.