Seclusion Episode Monitoring
Summary
Priory Hospital Burgess Hill developed a structured approach to monitoring seclusion episodes to improve patient safety and staff practice. By collating and reviewing Datix reports each month, the hospital moved beyond simply counting incidents to examining when and how seclusions occurred, what interventions were attempted beforehand, and whether seclusions ended in a timely way. This data-driven approach has supported open discussion, improved the quality of reporting, and provided evidence that has contributed to achieving accreditation for the male PICU ward.
The Challenge
The hospital wanted to ensure seclusion was only used when all other interventions had been exhausted, including offering or giving medication. Early reviews showed that evidence of these interventions was not always captured. There were also concerns about seclusion durations, particularly over weekends and evenings, and whether decisions to continue were affected by confidence levels or unfamiliarity among staff teams. In addition, the hospital wanted to understand whether there were patterns relating to the ethnicity of patients who were secluded or received rapid tranquilisation.
The Solution
The Governance Manager collected monthly Datix data and produced graphs showing seclusion numbers, times of day, durations, and patient ethnicity, as well as whether rapid tranquilisation or oral PRN medication was offered or given. This anonymised data was shared in Patient Safety Meetings attended by senior leaders, ward managers, and clinical leads, with Lived Experience Partners involved at times. Over time, the scope of data collection was expanded to answer further questions, including whether seclusions ended at weekends and whether all prior interventions were recorded. Staff learning showed that some interventions, such as oral medication or de-escalation, were not always being entered on Datix, and this insight drove improvements in recording practices.
Results & Next Steps
Greater scrutiny of seclusion reporting has improved how staff record interventions and highlighted the importance of capturing full information on datix. Staff now show better awareness of the impact of seclusion on patients and greater transparency in documenting prior interventions. Monitoring has reassured the hospital that seclusions are being ended in a timely manner, including out of hours. The approach supported the successful accreditation of the male PICU ward in February 2025, the first Priory PICU to achieve this. The method has since been shared across other Priory sites and can be adapted by hospitals using seclusion. Ongoing monitoring and questioning of the data will ensure continued improvement and patient-focused care.
