Seclusion Reduction

This toolkit provides information, resources and quality improvement (QI) tools for managers and clinicians to reduce and where possible, eliminate the use of seclusion and restraint in NSW health services. The resources may be adapted to suit local needs that is, for initial implementation, to review and improve current practices or support current practice in line with the Policy Directive of Seclusion and Restraint in NSW Health Settings (PD2020_004).

Continuous improvement is the path to safer healthcare. The World Health Organization defines safety as continuously improving the delivery of better health outcomes by minimising the risk and impact of unnecessary harm to patients. Every consumer deserves the safest possible care, and continuous improvement is the path to safer healthcare.

Modern healthcare is not only more effective but also more complex than ever, which has potential implications for consumer safety. Quality and safety systems help protect consumers from harm through identifying and mitigating risks and continuous improvement.

In order to improve safety for people accessing public health services and staff, NSW Health is committed to preventing seclusion and restraint. Seclusion and restraint must only be used as a last resort after less restrictive alternatives have been trialled or considered.

Seclusion Reduction is continuously monitored, reviewed and improved. This continuous improvement process system is informed by data including process, outcome, experience, and balancing measures and lessons and insights from the analysis of incidents.

This toolkit will assist mental health services to use improvement science and data to monitor, evaluate and improve least restrictive practices.

We use the term 'patient' or 'person' throughout this document rather than 'consumer' because the Toolkit is intended for a wide audience including services that are not specialist mental health services.

To join the Seclusion Reduction Quality Improvement Community of Practice (hosted via the Quality Improvement Data System - QIDS) the project team must first complete the online registration form (Note – QIDS is only available to NSW Health employees). Following this, the CEC will add the project team to the Seclusion Reduction Toolkit Improvement Project in QIDS.

Via QIDS, project teams will be able to:

  • Access additional resources and QI tools, including examples specific to the Seclusion Reduction toolkit
  • Manage their own improvement project
  • Collaborate with other teams undertaking Seclusion Reduction improvement.