TJC Clarifies the Role of Residents in Writing Restraint or Seclusion Orders
The Joint Commission has published a new FAQ addressing the role of residents, enrolled in graduate medical education program,s in writing orders for restraint or seclusion for behavioral health reasons. TJC standards require a licensed independent practitioner (LIP) to “…order restrain and seclusion when they are applied for behavioral reasons…” The restraint/seclusion order process requires the (LIP) to conduct a face-to-face evaluation of the patient.
TJC outlines four conditions under which a physician in a graduate medical education program can order restraint or seclusion for behavioral health reasons or conduct the required face-to-face evaluation of a patient in restraint or seclusion:
- “State law permits residents to perform these two activities under the auspices of a graduate medical education program.
- The graduate medical education program has provided relevant education and training for the resident in performing these two activities. [Graduate medical education programs accredited by the Accreditation Council on Graduate Medical Education would be expected to be in compliance with this requirement; the organization should be able to demonstrate compliance with any residency review committee citations related to this requirement.]
- In the judgment of the graduate medical education program, the resident is able to competently perform these two activities.
- The health care organization in which the resident provides patient care permits residents to perform these two activities.
- NOTE: A medical student has no legal status as a provider of health care services, therefore, would not be qualified to conduct an in-person evaluation of a patient in restraints or seclusion.”
All activities, including those outlined above, that are performed by the physicians in graduate medical education programs, are to be appropriately supervised.
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