Developing a new standard: A case study

Ross Woods, 2011

At the rehab centre, we had a very short policy on physical restraint. If one of the residents became violent, we needed some kind of policy on what to do and how to do it.

Then someone asked if we could be up a charge for assault or deprivation of liberty, and our policy clearly wasn't good enough. Somehow I got the job of writing a policy that was legally safe.

We had already done our homework on Workplace Health and Safety.

First, I phoned the industry association. The said, "No, we don't have anything to guide you, but we certainly need it."

Next, I phoned the department of health and spoke to the policy section. They said, yes, of course you can restrain someone who is violent if they are a danger to themselves or others. He referred me to their specialist, who never responded to my emails.

Then I did an Internet search. Not very productive. Too many hits but no useful information. But when I set the search engine to specifically search the Department of Health, I found that the mental health nurses and the nurses' registration board both had sets of clear standards. I followed the references, and even found a medical article listing many risk factors. These also led me to have a look at the legislation, such as the Mental Health Act.

I also asked several others:

• A couple of people who work in juvenile detention were more interested in helping kids, and let the tough-guy staff do any physical restraint. But one of them gave me a copy of their training materials.
• A medical doctor who worked in an emergency room that had lots of violent drug addicts come in. Oddly, the hospital rules were at odds with the published standards.

In the end, I had a series of useful documents:

• The first interview from the Department of Health.
• Half a dozen Acts of Parliament.
• Two very well-written sets of professional standards from a related industry.
• Some articles.
• Training materials from a different industry area.

The pattern was very clear; all sources generally agreed on good practice. Some added useful details that others didn't, and some had industry-specific details that clearly only applied within that industry.

It was then simply a matter of compiling everything useful and drafting a standard that was applicable to our organization. It took a couple of edits, but in the end, I'd learnt a lot and had the only best practice guide in our industry for our state.