Hospitals hammered on ligature risk mitigation strategies. It’s a problem even when screening for patient risk issues.
The only acceptable strategy we’ve seen is one-to-one supervision. But, the term, “suicide precautions,” causes confusion. It’s a term used by hospitals as their lowest risk category. It includes patient checks every 15 minutes. The next level incorporates line of sight observations. One-to-one is the highest risk category. Unfortunately some surveyors perceive term “suicide precautions” as high risk.
Ligature Risk Mitigation Strategies
As a result, we advise that you:
- Make the patient bedrooms and bathrooms safer
- Use more liberal application of one-to-one until there is greater clarity
The Joint Commission designed a very thorough set of instructions for surveyors. It describes stratification of risk, like the methods used in the FGI Design Guide for the Built Environment. But, at present, we see TJC targeting potential hazards in group rooms and hallways with equal vigor. We hope this changes over time. In fact, these potential hazards are more easily mitigated through routine staff supervision and observation.
We learned that TJC established a task force to help provide clarity on priorities. Unfortunately, if surveys occur:
- Before the completion of recommendations
- In advance of CMS/TJC acceptance of any such recommendations
It creates nightmares.