Reviewer, Secure Room Guideline for Acute Psychiatry

Providence Health Care is updating their seclusion practice guideline for acute psychiatric settings and needs patient feedback to ensure the creation of a safe and person-centered best practice guideline! Read on to learn more about how to participate.

Open to: Patient partners in the Lower Mainland & Fraser Valley

Lead Organization or Department

Providence Health Care – St. Paul’s Hospital, Acute Psychiatry

Aim

In adult psychiatric settings, the use of seclusion is guided by a least restraints approach and used with the intention of protecting individuals from harm or preventing harm to others. Providence Health is currently reviewing its approach to the care of patients in seclusion and updating our practice guideline to meet provincial standards and include evidence-based practices. Join us to consult on our guideline which supports clinicians in carrying out clinical duties and reflect current best practice standards. Through this opportunity, the health care partner will work with you to include your ideas and concerns in recommendations for improving the guideline.

Level of Engagement

This opportunity is at the level of consult on the spectrum of engagement. The promise to you is that the health care partner will listen to and acknowledge your ideas and concerns, and provide feedback on how your input affected the decision.

Eligibility

If you have a strong interest in this work but have not yet completed a PVN orientation and volunteer agreement, are unsure if your experience is a good fit or feel another format of engagement would work better with your availability, please contact the engagement leader directly.

Logistics

Vacancies:2 Date, Time, Location: For the review, patient partners will meet with one staff member to review and discuss the guideline draft. A meeting will be scheduled at St. Paul’s Hospital during business hours based on patient partner availability. They would like to complete the review with the patient partner before the end of November.

Reimbursement

Expenses related to travel (e.g. transit, parking up to $18/day, approved mileage up to 60 km each way) to attend meetings will be reimbursed by Providence Health Care.

Background

The Ministry of Health (MoH) prioritizes preventive strategies known to help patients de-escalate, best practices for delivering seclusion when it is wholly unavoidable, and design and construction standards to ensure the safest and most reassuring environment in which to deliver the intervention. Definitions:

• The BC MoH (2012) defines seclusion as a physical intervention during which a patient perceived to be in psychiatric crisis is contained in a room that is either locked or “from which free exit is denied” (p.19).
• The use of seclusion in a secure room is an example of an environmental restraint (see Restraint Guideline). Restraints are defined as a means of controlling or restricting a person in cares’ freedom of movement through the use of any chemical, environmental, mechanical or physical intervention (BC Residential Care Regulations, 2016)

In light of evidence supporting patient-centered and trauma-informed care, mental health clinicians are encouraged to employ less restrictive techniques and to prevent seclusion whenever possible. The standards and guidelines from the MoH emphasize protecting the rights, dignity, health, and safety of individuals admitted to psychiatric facilities, while simultaneously ensuring the safest, most effective, and most satisfying working conditions for caregivers. The standards and guidelines apply to designated facilities in BC where secure rooms exist, specifically provincial mental health facilities, psychiatric units and observation units. Providence Health Care is currently reviewing its approach to the care of patients in seclusion and updating our practice guideline to meet MoH standards and include additional evidence-based practices (e.g., sensory modulation).

Health Care Partner Contact Information

Karen Estrin
Engagement Leader, Patient and Public Engagement | Lower Mainland & Sunshine Coast
604.668.8245
kestrin@bcpsqc.ca