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HMC Behavioral Health Hospital

Restraint Documentation at HMC Behavioral Health Hospital

At a glance

  • HMC serves as the leading government sponsored healthcare organization
  • 13 hospitals
  • 27 primary health care centers
  • Specialist hospitals include Psychiatric Hospital and Cancer Hospital
  • Provides care for over 2 million residents
  • Recently ranked top 5 Health care organizations by leading U.K. Think tank Legatum

Rationale

The use of documentation around physical restraints are a necessary part of treatment for many patients in the inpatient psychiatric setting. Without properly and consciously utilizing the technology available to practitioners, the continued care of the patient in restraints can become more dangerous. Using Cerner’s tool around restraint documentation allows clinicians to actively monitor patients in restraints and trigger tools keep the clinician alerted of when a new order is necessary.

The team at HMC Behavioral Health Hospital actively sought out this new functionality and it was included in the recent optimization project and go live at their hospital. The team was active and involved in the new solution launching.

The Problem

Prior to using the Cerner workflow for restraints::

  1. Difficulties reported in the timing of restraint orders.
  2. Trouble identifying when to re-order restraints.
  3. Hardships concerning how to initiate new orders for restraints.
  4. Patients at risk of potential overuse of restraints due to lack of automated tools to remind and trigger responses from clinicians.

Impact

There was little baseline data that was available prior to implementing this new workflow. Creating this new workflow has demonstrated several benefits for the clinicians and leaders at the hospital. They are as follows:

  1. Clinicians can now determine how long a patient has been in restraints.
  2. Automated reporting for leaders is becoming available so the trending of data and oversight can take place.
  3. Compliance with Joint Commission International Standards is now in place. The order for restraints now must be reentered every 2 hours, which is in line with Joint Commission Standards.
  4. Identification of patients in restraints for longer than the prescribed time is becoming much easier for clinicians to track.

Data

  • Prior to implementation, no baseline data was available.
  • In June, the average episode of a patient in restraints was 59 minutes before the patient was assessed and a new order was placed.
  • In July, the average episode of a patient in restraints was 66 minutes before the patient was assessed and a new order was placed.
  • No episode of restraints exceeded the 120 minute requirement for assessment and reorder.

Key benefits

  • Patient Safety increased
  • Leveraged expertise of Cerner Consultants
  • Trained staff on restraint workflow
  • All patients in restraints will be closely monitored
  • Average 65 minutes per restraint episode before assessment and reorder took place since launch
  • Trending data now available

Next Steps

HMC Behavioral Health is looking forward to the new partnership with Cerner on this project and many others. This is the first of many steps forward that will enable the staff and leadership to enhance the care they deliver to patients in the inpatient Behavioral Health setting.

View all Client Achievement stories
Client outcomes were achieved in respective settings and are not representative of benefits realized by all clients due to many variables, including solution scope, client capabilities and business and implementation models.