A Visual Dashboard to Monitor Restraint Use in Hospitalized Psychiatry Patients

Structured Abstract Background Restraint events are tracked using a duration rate as part of a national psychiatry quality reporting program and tracked annually. Visual dashboards can help track metrics in near real-time but are not used in psychiatric settings. Methods This observational study sought to characterize restraint events by extracting EMR data on restraint episodes between January 1, 2017 and December 31, 2019 in five inpatient units in one academic medical center. The data was also used to build a visual dashboard and calculate restraint metrics (duration and frequency) across locations and time. Results 540 distinct restraint events occurred during the study period. Highest restraint episode counts occurred during evening shift (55%), compared to daytime (37%) and nighttime (8%) shifts. Highest episode duration rates occurring in an adult unit (61% of total hours spent in restraints across all units), while highest episode counts occurring in the adolescent unit (48% of all restraint episodes). A visual dashboard with two views (summary and detailed) was created. The summary view integrates patient volume data (total patient hours per month) with total duration and number of episodes per month. The detailed view displays event frequency by hour of day, nursing shift, weekday, and patient length of stay at the time of restraint. Conclusions Visual dashboards can provide timely and efficient access to granular data elements and metrics related to restraint events, beyond the reporting requirement of a national quality program. Visual dashboards can reveal variations in restraint use and yield important opportunities for clinical quality improvement.