Description

This Commission review of incident management practices at five state psychiatric centers surfaced several decidedly positive findings: episodes of patient elopements were reduced by more than 80% from 1994 to 1996. When incidents jeopardizing patient safety are identified, patients are provided prompt protective measures and/or treatment services; and incident investigations usually were timely and thorough, though some facilities need to improve in these areas and in the use and composition of Incident Review Committees (IRCs).