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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.
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.
About Millcreek Behavioral Health Services
Millcreek Behavioral Health Services is a Psychiatric Residential Treatment Facility and an Intermediate Care Facility for the Mentally Retarded. In its mission to help children live healthier and more productive lives, Millcreek provides services to approximately 300 children each year through its residential programs, group homes, community based programs and special education schools. It was founded in 1977 in response to the unmet needs of state agencies and the public, and to serve the needs of these very special children.
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