Paying attention to small things

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Sometimes safety hinges on the smallest things, like hinges.

The last time The Joint Commission visited Hallmark Health System as part of its accreditation process, one of the site visitors (who had been a psychiatric nurse) pointed out that the hinges on doors in the 22-bed adult psychiatry unit (called Medical 6) at Melrose-Wakefield Hospital could present a safety risk to behavioral health patients who might seek to harm themselves.

Changing door hinges – even on the 39 doors in the unit – seems like a small fix, but it became a major renovation project, involving reframing every door to accommodate the new, non-protruding hinges. “The unit is more than 35 years old,” said Tom Gunning, BSN, RN, patient care director of behavioral health. “It wasn’t built initially to be a locked unit for patients with behavioral health issues, and the requirements, including safe environment building regulations, for caring for this population have changed. We used this opportunity to make several safety-related changes to protect our patients and staff.”

Besides the new door frames and hinges, improvements included purchasing new tamper-proof furniture that cannot be disassembled, upgrading patient bathrooms with hidden piping and integrated toilets, and installing door handles that release if too much pressure is applied.

The project took three months and involved closing half the unit at a time to accommodate the renovations. “We’re pleased with the result and confident that we have improved
safety on the unit for patients and staff,” said Gunning.


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