TJC Clarifies the Role of Residents in Writing Restraint or Seclusion Orders

PUBLISHED: Jun 18, 2018
Relevant to: Behavioral Health, Critical Access Hospitals, Hospitals

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:

  1. “State law permits residents to perform these two activities under the auspices of a graduate medical education program.
  2. 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.]
  3. In the judgment of the graduate medical education program, the resident is able to competently perform these two activities.
  4. The health care organization in which the resident provides patient care permits residents to perform these two activities.
    1. 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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