Effective behavioral crisis management is essential for patient and staff safety in healthcare settings. Although physical restraints are commonly used in acute care facilities, they present significant risks of harm and psychological trauma. This study assessed the impact of implementing a behavioral crisis management algorithm, combined with an educational component, on reducing restraint use in a pediatric emergency department. A quality improvement initiative was conducted across three pediatric emergency sites within one hospital system in the Southeastern U.S. This project examined restraint utilization three months before and after implementation of the algorithm. Forty-five emergency department clinicians participated in a structured one-hour training session on the use of the crisis management algorithm. Pre-intervention data indicated that many providers felt inadequately prepared to manage behavioral crises and were unfamiliar with existing crisis management guidelines. The use of physical restraints before the intervention was significantly high, around 73.25%. Post-intervention findings demonstrated a decrease in restraint use to approximately 46.15%, representing a 27% reduction in restraint utilization. Additionally, staff reported a 16% increase in competency and comfortability in using the algorithm, along with a 74% improvement in adherence to the crisis management protocol. These findings highlight the importance of structured protocols and competency-based training in minimizing restraint reliance. Future research should explore long-term outcomes and scalability of similar interventions in diverse healthcare settings.
