1.
Special
Circumstances include, but are not restricted to:
- Psychotropic medication refusals
- Indications of significant boundary issues
between a client and provider
- Client escalations
- Disclosures
- Suicide threat without plan or means
- Atypical behaviors
- Action or inaction by provider which causes
harm or injury to client
- Theft or destruction of property
- Acts of violence
2.
Emergencies
include, but are not restricted to:
- Suicide threat or attempt with plan and means
- Psychotropic medication error
- Runaway
- Accidents resulting in injury
- Any special circumstance listed above that
are considered critical or put clients or providers at serious risk
- Occupational exposure
- Toxic or hazardous chemical exposure
3.
Immediately
upon becoming aware of an incident, providers shall take all necessary and
appropriate action to ensure the safety and welfare of the client, assist the
client and/or family of the client to deal adequately with the situation, and
provide support. Such actions shall be taken with the knowledge and concurrence
of the client�s treatment providers and/or emergency pager support. Because
each client's situation is unique, the specific approach used in each case
should be unique. It is the responsibility of the� providers to design an emergency
and/or contingency plan resulting in providers working with a client having
pre-knowledge and understanding of least restrictive but effective intervention
measures.
4.
Immediately,
or as soon as possible, after an incident has been appropriately addressed, the
provider involved shall inform his/her supervisor or the staff person on call.
The supervisor or on-call person contacted will assist as needed to help the
provider carry out such actions as are necessary to provide appropriate
intervention and/or emotional support to the client, provider, and/or other
affected persons. Because each client and provider is different and responds
differently to such situations, a specific approach taken in a given situation
should be based upon the needs of the client and provider involved.
5.
As soon as
possible after the incident (not more than 24 hours), or becoming aware of the
incident, the provider shall complete a Community Care Critical Incident Report
and submit to his/her supervisor or the appropriate Case Coordinator. The
Critical Incident Report shall be filled out completely using objective,
observable, measurable language. Any witnesses to the incident should sign the
form in the space provided and can also complete a separate Critical Incident
Report.
6.
The writer
will submit to report to the Clinical Supervisor, or designee, for a quality
assurance review, debriefing and written recommendations. The report will then
be filed in the client's record with a copy being sent to the legal guardian
(or other non-agency case manager or guardian when appropriate).
7.
The client�s
providers shall review each Critical Incident in team meetings. It is
imperative that each team member is aware of all critical incidents,
interventions used, results of interventions, and possible plans for similar
incidents.
8.
The Clinical
Supervisor, or designee, upon review of Critical Incident Reports, may address
possible legal or liability issues involved. This person will also make
recommendations for further investigation or support to client or provider
(i.e., consultation with MANDT trainers; development of a contingency or
emergency plan; changes in Community Care policy, procedures, or practice; etc.).