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Open Forum
Published Online: 31 October 2014

Seclusion and Restraint as Measures of the Quality of Hospital Care: Any Exceptions?

Abstract

The Joint Commission has recently included seclusion and restraint as quality-of-care indicators for hospital-based inpatient psychiatric services. Their inclusion is the result of abuse of these practices, wide variation across hospitals, and cultural influences, including the consumer and recovery movements. Over the next few years, these indicators will increasingly influence treatment modalities available to hospitalized patients. This Open Forum provides a brief history of changing attitudes toward use of seclusion and restraint. It describes three clinical scenarios that highlight appropriate and humane use of seclusion and restraint and that illustrate the clinical complexities associated with their use. Potential unforeseen consequences of the reduction or elimination of seclusion and restraint are described.

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Go to Psychiatric Services
Go to Psychiatric Services

Cover: Woman Sitting on Couch Looking at Picture, by Alice Barber Stephens. Library of Congress, Prints and Photographs Division, DLC/PP-1933:0012.

Psychiatric Services
Pages: 1373 - 1375
PubMed: 25124498

History

Published ahead of print: 31 October 2014
Published online: 1 November 2014
Published in print: November 01, 2014

Authors

Details

Michael H. Sacks, M.D.
Dr. Sacks is with the Department of Psychiatry, New York–Presbyterian Hospital, New York City. Dr. Walton is with the Department of Psychiatry, NYU Langone Medical Center, New York University, New York City. Send correspondence to Dr. Walton (e-mail: [email protected]).
Michael F. Walton, M.D.
Dr. Sacks is with the Department of Psychiatry, New York–Presbyterian Hospital, New York City. Dr. Walton is with the Department of Psychiatry, NYU Langone Medical Center, New York University, New York City. Send correspondence to Dr. Walton (e-mail: [email protected]).

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