200673 Reducing restraint and seclusion: Evaluation of systems change in Connecticut

Wednesday, November 11, 2009: 1:10 PM

Felicia Griffin-Fennell, PhD , Research Division, CT Department of Mental Health and Addiction Services, Hartford, CT
Linda K. Frisman, PhD , CT Dept Mental Health & Addiction Services, Research Division MS # 14 RSD, Hartford, CT
Julia E. Thomson-Philbrook, MA , Research Division, CT Department of Mental Health and Addiction Services, Hartford, CT
In order to evaluate the efforts of CT state hospitals to reduce seclusion and restraint, we implemented a multi-layered, mixed-method evaluation. In addition to data collected for the SAMHSA-required national evaluation including changes in policies and procedures and rates of seclusion and restraint by patient characteristics, we sought to monitor issues that were important to CT stakeholders, as identified by advisory committees at the state and local levels. These include rates of injury of staff and patients, the need for 1:1 observations, and the satisfaction with new procedures and the hospital environment. Evaluation methods included participant observation, semi-structured interviews, focus groups, client and staff surveys, and review of administrative information. Frequent feedback to the project director and advisory groups helped to shape the initiative as it unfolded. We will present data on the changes over the early course of the initiative and describe the ways that data from multiple sources were blended to draw conclusions. We will describe how hospital context facilitated or impeded the ability of the hospital to launch changes, and the correlation between trauma-informed care system changes and reductions in seclusion and restraint.

Learning Objectives:
Attendees will be able to: 1. Identify evaluation methods for systems change in state mental hospitals 2. Describe factors related to successful reduction in use of restraint and seclusion

Keywords: Hospitals, Public Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a MA in Public Policy and Public Administration I am part of the evaluation team for the reduction of restraint and seclusion state incentive grant at the Research Division of the CT Dept of Mental Health and Addiction Services. I am a doctoral student at the University of Connecticut I have presented papers at the American and Midwest Political Science Associations annual meetings, as well as at student conferences in Connecticut and Massachusetts.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.