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The Engagement Model for reducing seclusion and restraint: 13 years later. 2015

Martha Blair, and Fletcher Moulton-Adelman

In 2001, an inpatient psychiatric unit sought to greatly reduce, or even eliminate, the use of seclusion and restraint by initiating the Engagement Model. Despite many changes in management and staff, the model has remained largely intact and effective during the past 13 years. The current article reflects on key clinical interventions and leadership approaches that have helped sustain the culture change undertaken to better serve patients on this unit.

UI MeSH Term Description Entries
D007297 Inpatients Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment. Inpatient
D010356 Patient Isolation The segregation of patients with communicable or other diseases for a specified time. Isolation may be strict, in which movement and social contacts are limited; modified, where an effort to control specified aspects of care is made in order to prevent cross infection; or reverse, where the patient is secluded in a controlled or germ-free environment in order to protect him or her from cross infection. Home Isolation,Isolation, Home,Isolation, Patient,Negative Pressure Isolation,Negative Pressure Patient Isolation
D012149 Restraint, Physical Use of a device for the purpose of controlling movement of all or part of the body. Splinting and casting are FRACTURE FIXATION. Immobilization, Physical,Physical Restraint,Physical Immobilization,Physical Restraints,Restraints, Physical
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006778 Hospitals, Psychiatric Special hospitals which provide care to the mentally ill patient. Mental Hospitals,Hospitals, Mental,Mental Institutions,Psychiatric Hospitals,Hospital, Mental,Hospital, Psychiatric,Institution, Mental,Institutions, Mental,Mental Hospital,Mental Institution,Psychiatric Hospital
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001523 Mental Disorders Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. Mental Illness,Psychiatric Diseases,Psychiatric Disorders,Psychiatric Illness,Behavior Disorders,Diagnosis, Psychiatric,Mental Disorders, Severe,Psychiatric Diagnosis,Illness, Mental,Mental Disorder,Mental Disorder, Severe,Mental Illnesses,Psychiatric Disease,Psychiatric Disorder,Psychiatric Illnesses,Severe Mental Disorder,Severe Mental Disorders
D015397 Program Evaluation Studies designed to assess the efficacy of programs. They may include the evaluation of cost-effectiveness, the extent to which objectives are met, or impact. Evaluation, Program,Family Planning Program Evaluation,Program Appropriateness,Program Effectiveness,Program Sustainability,Appropriateness, Program,Effectiveness, Program,Evaluations, Program,Program Evaluations,Program Sustainabilities,Sustainabilities, Program,Sustainability, Program

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