Hartford Hospital’s IDEA Team Tapped as 2018 Clinical Team of the Year
The Institute of Living Innovative De-escalation Emergency Assistance (IDEA) team was awarded the Hartford Hospital Team of the Year award for 2018.
The IDEA team focuses on developing and improving best practices at the IOL for reduction of seclusion, restraint and violence.
The following excerpt is from the nomination submitted for the team:
“Management of violent and aggressive behavior is a major challenge in psychiatry. Traditional approaches frequently include seclusion and restraint; interventions that can be traumatizing for both patients and staff. Seclusion and restraint have been used in the care of the psychiatric ill since the early 1800s when the first of the early ‘asylums’ were established. However, due to increasing concern that these practices may be counter-therapeutic, dangerous to patients and staff, and often avoidable, the IOL leadership team recognized that seclusion and restraint reduction must be a priority for the IOL and that alternative management strategies to prevent the use of these modalities were critically needed (Blair et al., 2017).
“Through this exploration, we learned that Butler Psychiatric Hospital in Rhode Island had developed a de-escalation team to reduce seclusion and restraint that had proven very successful. As such, we invited Butler Hospital to visit us in November 2015 to speak with us about this approach. After this visit, and many multidisciplinary discussions involving both leadership and frontline staff, we decided that the de-escalation team was the one practice change we had not yet implemented and therefore, decided to create a pilot. Hence, the IDEA team was born!
The IDEA Team, created to help reduce seclusion, restraint and violence, was named Hartford Hospital’s 2018 Clinical Team of the Year.
“De-escalation of potentially violent incidents is central to reducing seclusion and restraint. The IDEA team was developed to enhance our de-escalation initiatives, and was based on the belief that the earliest intervention focused on the best possible communication with the patient would provide the greatest chance for peaceful problem resolution and an effective means to improve — and ensure — patient and staff safety while supporting the patient’s own coping skills. The philosophy behind the IDEA team is not to ‘take over’ or control; rather, to collaborate and support. The goal is to avoid physical restraint (except as a last resort), mitigate risk and injury, improve the patient experience, and support the patient’s coping skills while enhancing the staffs critical thinking skills and reducing their fear and anxiety. This has resulted in a true ‘culture change’ at the IOL!
“In the first few months after the IDEA team began, the restraint rate decreased approximately 75%, from 4.77 to 1.239; the seclusion use has decreased substantially as well, from a rate of 2.13 to .48.
“Another important point that must be highlighted is that the members of the IDEA team spend a great deal of time with the patient struggling with agitation. Being available to the patient during this very difficult time conveys not only caring, but true respect for that individual.
“After an event on the unit, the IDEA team debriefs with the staff to analyze the situation (what worked, or what might have been done differently). This dovetails nicely with our quality improvement model at the IOL, as well as with the high reliability organization we are striving for at HH. We also schedule post-incident debriefings, monthly review, and data sharing in our weekly IDEA team meetings and in our IOL Quality Council.”