0
R e c o v e r y

Thinking Out of the Box with Recovery
No-Force-First

Eugene Johnson, President/CEO
Creating Extraordinar...
R e c o v e r y

Recovery Innovations
•
•
•
•

Founded in 1990 to serve Maricopa County
Private not-for-profit
Accredited ...
R e c o v e r y

Recovery Innovations
• Recovery Response Centers
– Peoria, AZ 1996
– Henderson, NC 2009
– Pierce County, ...
1996

X

X

5 16 16

RRC Henderson

Henderson, NC

2006

X

X

2

2

RRC Pierce Co

Tacoma, WA

2009

X

X

RRC Ellendale
...
Phoenix Recovery
Response Center
Living Room
9
R e c o v e r y

No Force First
Anthony, William. An Elephant in the Living Room.
Psychiatric Rehabilitation Journal, Vol....
No Force First Strategy
“The leadership of RI believes the elimination of all types of force
has many benefits to their or...
No Force First Outcomes
Reduction in ED mental health patients
Bebee Hospital ED Transfers to IMD
90
80
70

83
72 73

61 6...
No Force First Outcomes;
Reduced Hospitalizations
Psychiatric Recovery Center Hospitalizations
30.0%

25.0%

20.0%

15.0%
...
R e c o v e r y

No Force First Outcomes
• In the first month (June 2011) of Recovery
Innovations operations the hospital ...
R e c o v e r y

No Force First Outcomes
• Following the implementation of mobile response
and the RRC in Pierce County, W...
R e c o v e r y

No Force First - Zero Restraint
• Declaration: Stop the violence that
results in trauma, injury and even ...
R e c o v e r y

Getting to Zero; The Results
• Achieved zero mechanical restraint in
month eight, dropping from 5.5/month...
12

10

6

4

2

PRC West Restraints

12

8
8 7 7
6
88

4
33
6 6

4
2
1
1
11
000000000000 00000 00000000000000000

0

Feb
...
R e c o v e r y

Getting to Zero; The Results
•
•
•
•

No increase in staff injury.
No increase in police events.
No incre...
R e c o v e r y

No Force First – Peer Support
• Stop the violence
• Use lots of peer support
– A minimum of 25%.
– Today,...
R e c o v e r y

No Force First – Peer Support
• Hope and Engagement. Sharing personal
recovery experiences. “If she/he ca...
R e c o v e r y

What Shows Up with Peers on the Team?
• The Peer Support Specialist’s own
recovery is strengthened throug...
R e c o v e r y

Survey of Peer Employees
• Anonymous Internet survey sent to 355 peer
employees with at least 2 months of...
R e c o v e r y

Results
• Of those receiving disability benefits at
the time of employment, 59% went off
benefits after b...
R e c o v e r y

Financial Impact
• $8 million in annual salaries.
• $1.2 million paid in income taxes.
• $488,280 estimat...
Personal benefits from being a peer support provider

Percent

Helping others has helped me in my own recovery
I feel more...
R e c o v e r y

What Shows Up with Peers on the Team?
• The Peer Support Specialist’s own
recovery is strengthened throug...
R e c o v e r y

No Force First – Healing Spaces
• Stop the violence
• Use lots of peer support
• Create Healing Spaces

©...
R e c o v e r y

No Force First – Healing Spaces
• Hospitality; be welcoming and friendly

© Recovery Innovations, Inc
Have a welcome sign on the door
Have a welcome sign on the door

Recovery Response Network
Jacksonville, NC
Have a smile on our face
R e c o v e r y

No Force First - Healing Spaces
• Institutional feeling replaced by “welcoming
and friendly.” Spirit of h...
Recovery Response Center Front Room
Jacksonville, NC
R e c o v e r y

No Force First - Healing Spaces
• Institutional feeling replaced by “welcoming
and friendly.” Spirit of h...
R e c o v e r y

No Force First - Healing Spaces
• Institutional feeling replaced by “welcoming
and friendly.” Spirit of h...
R e c o v e r y

No Force First - Healing Spaces
• Institutional feeling replaced by “welcoming
and friendly.” Spirit of h...
Recovery Response Center Living Room
Jacksonville, NC
R e c o v e r y

No Force First - Healing Spaces
• Institutional feeling replaced by “welcoming and
friendly.” Spirit of h...
R e c o v e r y

No Force First - Healing Spaces
• Institutional feeling replaced by “welcoming and
friendly.” Spirit of h...
Artist Jeff Jones created illustrations of our
nine dimensions of wellness
R e c o v e r y

No Force First – Create Alternatives
• Stop the violence
• Use lots of peer support
• Create Alternatives...
R e c o v e r y

No Force First – Create Alternatives
The Peer Living Room
• Offers a hospitality
alternative to tradition...
R e c o v e r y

What Happens in the Living Room?
• Peers share their stories of hope.

• Negotiate each person’s needs
in...
Outcomes; Reduced Hospitalizations
Psychiatric Recovery Center Hospitalizations
30.0%

25.0%

One hospitalization
cost $9,...
R e c o v e r y

No Force First – Create Alternatives
• In the first month of Recovery Innovations operations the
hospital...
R e c o v e r y

No Force First – New Language
•
•
•
•

Stop the violence
Use lots of peer support
Create a Healing Space
...
R e c o v e r y

A New Language of Hope and Inspiration
Crisis

Opportunity

Crisis Center

Recovery Response Center

Inta...
R e c o v e r y

No Force First – New Language
•
•
•
•

Stop the violence
Use lots of peer support
Create a Healing Space
...
R e c o v e r y

No Force First – Risk Sharing
•
•
•
•

Stop the violence
Use lots of peer support
Create a Healing Space
...
No Force First - Risk Sharing
Old Way ~ Managing and Controlling

New Way ~ Risk Sharing ~No Force First

Full body strip ...
1. Routine

2. Moderate

3. High

Risk Sharing Issue
Is age a factor in assigning space?

□ Yes

□ No

Comments

Is gender...
R e c o v e r y

No Force First
•
•
•
•

Stop the violence
Use lots of peer support
Create a Healing Space
Create non-hosp...
R e c o v e r y

celebrate…
the best is yet to come!

© Recovery Innovations, Inc

58
Recovery Innovations 2013
Recovery Innovations 2013
Recovery Innovations 2013
Recovery Innovations 2013
Recovery Innovations 2013
Recovery Innovations 2013
Recovery Innovations 2013
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Transcript of "Recovery Innovations 2013"

  1. 1. R e c o v e r y Thinking Out of the Box with Recovery No-Force-First Eugene Johnson, President/CEO Creating Extraordinary Opportunities Lori Ashcraft, Ph.D. Executive Director www.recoveryinnovations.org © Recovery Innovations, Inc 1
  2. 2. R e c o v e r y Recovery Innovations • • • • Founded in 1990 to serve Maricopa County Private not-for-profit Accredited by JCAHO since 1992 Integrated professional and peer staff. 800 staff and 62% are peers providing peer support. • World leader in recovery transformation that began in 2000 and has been our guiding vision • 40,000 individuals served annually in five states and New Zealand in 22 locations. • Recovery training in 32 states and five countries abroad. © Recovery Innovations, Inc
  3. 3. R e c o v e r y Recovery Innovations • Recovery Response Centers – Peoria, AZ 1996 – Henderson, NC 2009 – Pierce County, WA 2010 – Ellendale, DE 2012 – Houston – Colorado? • Living Rooms only – Wenatchee, WA 2010 – Bakersfield, CA 2011 © Recovery Innovations, Inc
  4. 4. 1996 X X 5 16 16 RRC Henderson Henderson, NC 2006 X X 2 2 RRC Pierce Co Tacoma, WA 2009 X X RRC Ellendale Ellendale, DE 2012 X X Hope House Bakersfield, CA 2011 X RRC Houston Houston, TX 2014 X Living Room Peoria, AZ Retreat RRC Peoria Location Region Population Funder Annual Funding 3.9 M Magellan $8.0 M 250 K Cardinal Innovations $2.4 M 800 K Optum Health Pierce $4.1 M Urban Rural Annual Admits Involuntary Begin Date Voluntary Recovery Response Center Program Capacity Front Room Legal Status Ave Length of Stay (days) Recovery Response Centers 1.7 8 750 7.2 5 4 10 2,500 2.0 5 6 0 1,650 0.5 X 350 K Delaware DSAMH $3.0 M 14 X 3,500 X 200 20.5 X 850 K Kern County $1.7 M 16 16 3.500 1.7 4M Optum Health $6.0 M X X X 4
  5. 5. Phoenix Recovery Response Center Living Room
  6. 6. 9
  7. 7. R e c o v e r y No Force First Anthony, William. An Elephant in the Living Room. Psychiatric Rehabilitation Journal, Vol. 29 Number 3, Winter 2006. p. 155 “There is no such thing as forced recovery.” “The conditions that generate forced treatment are easily trumped by our seeming indifference to the massive use of force in the mental health culture… “Let us commit to figuring out how to stop our mindless use of force. Let us use our best minds to figure out how to extricate our field from being society’s purveyors of force.” © Recovery Innovations, Inc 10
  8. 8. No Force First Strategy “The leadership of RI believes the elimination of all types of force has many benefits to their organization. The very presence of coercion within their crisis centers would reflect poorly on all the other programs run by RI, and most importantly harm the very people RI is trying to help. RI believes that the highest price of all is the price paid by the people being restrained ---due to their recovery being stalled by a practice that can disempower them; break their spirit; and reignite a sense of helplessness and hopelessness. The use of force is very traumatizing in nature, especially for those who have a history of physical or sexual abuse. The development and implementation of a NFF policy within a recovery approach to helping has convinced the authors that the implementation of a NFF policy should become a best practice in the treatment of people with severe psychiatric disorders.” “The Development and Implementation of No Force First as a Best Practice.” Psychiatric Services, May, 2012
  9. 9. No Force First Outcomes Reduction in ED mental health patients Bebee Hospital ED Transfers to IMD 90 80 70 83 72 73 61 63 60 62 55 60 Number 50 Transfers 40 30 20 10 0 44 39 51 44 42 36 46 43 36 • Beebe Healthcare is a 210 bed general hospital serving southern Delaware. • In August, 2012 Recovery Innovations opened a 23-hour RRC nearby. Beebe reports a significant reduction in ED psychiatric patients following the RRC opening.
  10. 10. No Force First Outcomes; Reduced Hospitalizations Psychiatric Recovery Center Hospitalizations 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% 3 -0 ul J p Se 3 -0 3 -0 ov N Central 4 -0 an J M 4 -0 ar West M 4 -0 ay Total 4 -0 ul J During the period shown there were an average of 900 PRC admissions per month. A reduction in hospitalization rate from 20% to 10% =1,080 annual hospital admissions = $10 M + per year (($550 per hospital day with an average length of stay of 18 days in 2003).
  11. 11. R e c o v e r y No Force First Outcomes • In the first month (June 2011) of Recovery Innovations operations the hospital Emergency Department in North Carolina reported a drop in involuntary hospitalizations from 57% to 35%. • In April 2012, 181 individuals were served by the RI Pierce Recovery Response Center with only 4 individuals (2.2%) discharged to a psychiatric inpatient bed. • Hospitalizations were reduced by 300% in Wenatchee, Washington in the first six months of Recovery Innovations Community Response Team (mobile team: DMHP + CPS). © Recovery Innovations, Inc
  12. 12. R e c o v e r y No Force First Outcomes • Following the implementation of mobile response and the RRC in Pierce County, WA, OptumHealth reports • a reduction in 19% saving $1.5M • Reduction in Involuntary Treatment of 32% saving $2M • In Pierce County Peer Recovery Team served 120 individuals in 2011 who had 131 hospitalizations in the 12 months prior reduced to 23 hospitalization in the 12 months after the service. (Medicaid Health Plans of America, “Best Practices Compendium,” 2012) Recovery Innovations, Inc 15 ©
  13. 13. R e c o v e r y No Force First - Zero Restraint • Declaration: Stop the violence that results in trauma, injury and even death of people served and our staff. • Listen to the experience of those we serve. © Recovery Innovations, Inc 16
  14. 14. R e c o v e r y Getting to Zero; The Results • Achieved zero mechanical restraint in month eight, dropping from 5.5/month. • In the second Center it took 15 months. • Once we achieved the results, elimination became imbedded in our practice. Ashcraft, Lori; Anthony, Bill. “Eliminating Seclusion and Restraint in Recovery-Oriented Crisis Services.” Psychiatric Services, October 2008. © Recovery Innovations, Inc 17
  15. 15. 12 10 6 4 2 PRC West Restraints 12 8 8 7 7 6 88 4 33 6 6 4 2 1 1 11 000000000000 00000 00000000000000000 0 Feb M a 00 y -0 Au 0 gNo 00 vFeb 00 M a 01 y -0 Au 1 gNo 01 vFeb 01 M a 02 y -0 Au 2 gNo 02 vFeb 02 M a 03 yAu 0 3 gNo 03 vFeb 03 -04 Jan -0 Ap 0 r- 00 Ju l0 Oct 0 -0 Jan 0 - 01 Ap r- 0 Ju l- 1 0 Oct 1 -0 Jan 1 -0 Ap 2 r- 02 Ju l0 Oct 2 -0 Jan 2 - 03 Ap r- 0 Ju l- 3 0 Oct 3 -0 Jan 3 -0 Ap 4 r- 04 Recovery Innovation’s Recovery Symbol: Zero Restraint 18 18 16 14 4 2 12 PRC Central Restraints 14 4 1 13 12 12 12 10 9 9 9 9 9 9 8 8 7 7 8 66 6 6 f 6 5 5 5 5 6 4 4 4 4 4 4 4 2 4 3 3 2 2 2 22 11 1 11 0 0 00 0
  16. 16. R e c o v e r y Getting to Zero; The Results • • • • No increase in staff injury. No increase in police events. No increase in chemical restraint. Today our Centers in CA, WA, NC, DE are licensed with no seclusion or restraint room. © Recovery Innovations, Inc 19
  17. 17. R e c o v e r y No Force First – Peer Support • Stop the violence • Use lots of peer support – A minimum of 25%. – Today, 62% of Recovery Innovations direct service staff are Peer Specialists, 496 out of 800. © Recovery Innovations, Inc 20
  18. 18. R e c o v e r y No Force First – Peer Support • Hope and Engagement. Sharing personal recovery experiences. “If she/he can do it, so can I.” • Empathy. Understanding through the personal experience of having “been there”. • Mutuality. Giving and receiving help and support with respect based on a shared experience. • Being with rather than fixing. • Mutual Responsibility for the relationship • Intentional Relationship © Recovery Innovations, Inc 21
  19. 19. R e c o v e r y What Shows Up with Peers on the Team? • The Peer Support Specialist’s own recovery is strengthened through service. © Recovery Innovations, Inc 22
  20. 20. R e c o v e r y Survey of Peer Employees • Anonymous Internet survey sent to 355 peer employees with at least 2 months of employment. • 253 responded, 70% response rate. • Prior to employment, 66% were unemployed. • 35% had been unemployed more than three years. • Average hours worked per week = 30. Rogers, Sally; Johnson, Eugene. “Personal and Societal Benefits of Providing Peer Support.” Psychiatric Services, publication pending © Recovery Innovations, Inc 23
  21. 21. R e c o v e r y Results • Of those receiving disability benefits at the time of employment, 59% went off benefits after becoming employed. • 45% went off Medicaid. • 16% discontinued a housing subsidy. • 69% discontinued food stamps. © Recovery Innovations, Inc 24
  22. 22. R e c o v e r y Financial Impact • $8 million in annual salaries. • $1.2 million paid in income taxes. • $488,280 estimated savings in disability payments. © Recovery Innovations, Inc 25
  23. 23. Personal benefits from being a peer support provider Percent Helping others has helped me in my own recovery I feel more self-confident I feel more emotionally stable I am more satisfied with my life in general I am more interested in my future career opportunities now I am more financially stable I have been able to connect more with family I am able to do more recreational/leisure time things I have been able to socialize more with friends I have been able to begin saving money I have taken a paid vacation I have a nicer place to live I now have company benefits like medical or dental coverage I purchased my own vehicle I have been able to reduce the medication 87.1% 78.7% 72.7% 72.3% 68.7% 67.1% 44.2% 42.6% 39.8% 38.2% 34.9% 32.5% 31.3% 26.5% 20.5%
  24. 24. R e c o v e r y What Shows Up with Peers on the Team? • The Peer Support Specialist’s own recovery is strengthened through service. • Peer Support Specialists help others recover through engagement, hope, and mutual relationship/friendship. – Results; seclusion and restraint were eliminated in 8 months and in 15 months – Results; 180 bed County Hospital after one year reported a 36% reduction in seclusion and a 48% reduction in restraint. • Peer Support Specialists help the organization recover. © Recovery Innovations, Inc 27
  25. 25. R e c o v e r y No Force First – Healing Spaces • Stop the violence • Use lots of peer support • Create Healing Spaces © Recovery Innovations, Inc 28
  26. 26. R e c o v e r y No Force First – Healing Spaces • Hospitality; be welcoming and friendly © Recovery Innovations, Inc
  27. 27. Have a welcome sign on the door
  28. 28. Have a welcome sign on the door Recovery Response Network Jacksonville, NC
  29. 29. Have a smile on our face
  30. 30. R e c o v e r y No Force First - Healing Spaces • Institutional feeling replaced by “welcoming and friendly.” Spirit of hospitality. • Use lots of light and open spaces. © Recovery Innovations, Inc
  31. 31. Recovery Response Center Front Room Jacksonville, NC
  32. 32. R e c o v e r y No Force First - Healing Spaces • Institutional feeling replaced by “welcoming and friendly.” Spirit of hospitality. • Use lots of light and open spaces. – No “us” and “them.” Take down the barriers. – Balance between privacy and community. © Recovery Innovations, Inc
  33. 33. R e c o v e r y No Force First - Healing Spaces • Institutional feeling replaced by “welcoming and friendly.” Spirit of hospitality. • Use lots of light and open spaces. – No “us” and “them.” Take down the barriers – Balance between privacy and community. • Use warm colors with bright accents. © Recovery Innovations, Inc
  34. 34. R e c o v e r y No Force First - Healing Spaces • Institutional feeling replaced by “welcoming and friendly.” Spirit of hospitality. • Use lots of light and open spaces. – No “us” and “them.” Take down the barriers. – Balance between privacy and community. • Use warm colors with bright accents. • Comfortable non-institutional furnishings. © Recovery Innovations, Inc
  35. 35. Recovery Response Center Living Room Jacksonville, NC
  36. 36. R e c o v e r y No Force First - Healing Spaces • Institutional feeling replaced by “welcoming and friendly.” Spirit of hospitality. • Use lots of light and open spaces. – No “us” and “them.” Take down the barriers. – Balance between privacy and community. • Use warm colors with bright accents. • Comfortable non-institutional furnishings. • Label rooms using recovery language. – Front room, Retreat, Living Room. – Celebration suite, Room Hope, Learning Studio, etc. © Recovery Innovations, Inc
  37. 37. R e c o v e r y No Force First - Healing Spaces • Institutional feeling replaced by “welcoming and friendly.” Spirit of hospitality. • Use lots of light and open spaces. – No “us” and “them.” Take down the barriers. – Balance between privacy and community. • Use warm colors with bright accents. • Comfortable non-institutional furnishings. • Label rooms using recovery language. – Front room, Retreat, Living Room. – Celebration suite, Room Hope, Learning Studio, etc. • Add art and plants © Recovery Innovations, Inc
  38. 38. Artist Jeff Jones created illustrations of our nine dimensions of wellness
  39. 39. R e c o v e r y No Force First – Create Alternatives • Stop the violence • Use lots of peer support • Create Alternatives © Recovery Innovations, Inc 46
  40. 40. R e c o v e r y No Force First – Create Alternatives The Peer Living Room • Offers a hospitality alternative to traditional psychiatric crisis services and hospitals. • Staffed with Peer Support Specialists around the clock working alongside professionals. • Following a “recovery partnership” and a “getting to know you” meeting, people may choose to be a guest in the Living Room. “Crisis Services in the Living Room; an Environment with Peer Supports Helps People in Crisis.” Behavioral Healthcare Magazine. July, 2006 © Recovery Innovations, Inc
  41. 41. R e c o v e r y What Happens in the Living Room? • Peers share their stories of hope. • Negotiate each person’s needs individually. • Guests develop recovery plans. • Make connections with the community • Guests make plans for “next steps” © Recovery Innovations, Inc 48
  42. 42. Outcomes; Reduced Hospitalizations Psychiatric Recovery Center Hospitalizations 30.0% 25.0% One hospitalization cost $9,900 ($550 per hospital day with an average length of stay of 18 days). During the period shown there were an average of 900 PRC admissions per month. 20.0% 15.0% 10.0% 5.0% 0.0% 3 l- 0 Ju p Se 3 -0 3 -0 ov N Central 4 -0 an J M 4 -0 ar West M 4 -0 ay Total 4 l- 0 Ju A reduction in hospitalization rate from 20% to 10% =1,080 annual hospital admissions = $10,692,000 per year.
  43. 43. R e c o v e r y No Force First – Create Alternatives • In the first month of Recovery Innovations operations the hospital Emergency Department in North Carolina reported a drop in involuntary hospitalizations from 57% to 35%. • In Pierce County Peer Recovery Team served 120 individuals in 2011 who had 131 hospitalizations in the 12 months prior reduced to 23 hospitalization in the 12 months after the service. (Medicaid Health Plans of America, “Best Practices Compendium,” 2012) • In April 2012, 181 individuals were served by the RI Pierce Recovery Response Center with only 4 individuals (2.2%) discharged to a psychiatric inpatient bed. • Hospitalizations have been reduced by 300% in Wenatchee, Washington in the first six months of Recovery Innovations Opportunity services. © Recovery Innovations, Inc
  44. 44. R e c o v e r y No Force First – New Language • • • • Stop the violence Use lots of peer support Create a Healing Space Create non-hospital alternatives – Living Room, Restart, Peer Recovery Team • Change the language and documentation © Recovery Innovations, Inc
  45. 45. R e c o v e r y A New Language of Hope and Inspiration Crisis Opportunity Crisis Center Recovery Response Center Intake Recovery Partnership Assessment Getting to Know Each Other Staffing Mutual Planning Meeting Psycho-social history Telling My Story Treatment Plan Counseling Recovery Solutions Recovery Coaching Consumer Guest © Recovery Innovations, Inc 52
  46. 46. R e c o v e r y No Force First – New Language • • • • Stop the violence Use lots of peer support Create a Healing Space Create non-hospital alternatives – Living Room, Restart, Peer Recovery Team • Change the language • Change the documentation. – Use the person’s name – Use ordinary language in the record – Include the person as a partner in the documentation process © Recovery Innovations, Inc
  47. 47. R e c o v e r y No Force First – Risk Sharing • • • • Stop the violence Use lots of peer support Create a Healing Space Create non-hospital alternatives – Living Room, Restart, Peer Recovery Team • Change the language • Implement risk-sharing © Recovery Innovations, Inc
  48. 48. No Force First - Risk Sharing Old Way ~ Managing and Controlling New Way ~ Risk Sharing ~No Force First Full body strip search Safety through risk-sharing discussion All personal property secured After review, property retained by guest Staff behind the wall in glass enclosure No walls. Open spaces promote relationship Uniformed security guards 24/7 Safety through relationship Video surveillance throughout Relationship; being-with promotes healing All staff wear hospital scrubs Street clothes minimize us/them barriers Seclusion room to control Use de-escalation techniques and relationship Lack of privacy Guest can have key to their bedroom Common toilet/shower facility Toilet/shower in guest bedroom Outside and smoke break limited Open outside access Once a week visiting Family and friends welcome at all times No unsupervised phone access Guests keep their cell phone Outside communication restricted Internet and email available All medications staff administered Medication self-administration is offered
  49. 49. 1. Routine 2. Moderate 3. High Risk Sharing Issue Is age a factor in assigning space? □ Yes □ No Comments Is gender a factor in assigning space? □ Yes □ No Comments Rate each item Describe the Risk Sharing Plan for 3 or higher Developmental Level Risk Rating Plan: Danger to Self Risk Rating Plan: Danger to Others Risk Rating Plan: Other Self Harm Concerns Risk Rating Plan: Trauma History Risk Rating Plan: Elopement risk Risk Rating Plan: Recent Domestic Violence Concerns Risk Rating Plan: Need for Privacy/Quiet Privacy Rating Plan: Physical Disabilities Risk Rating Describe: Medical Needs Risk Rating Describe: Substance Intoxication Risk Rating Plan: Substance Withdrawal Risk Risk Rating Plan: Level of Medication Monitoring Needed Level Plan: Fire Setting Concerns Risk Rating Plan: Other Concerns Risk Rating Describe: Space Assignment □ Private Room Engagement Support □ 1:1 Continuous Companion Other Risk Sharing Comments □ Double Room okay □ Wellness Checks q 15 □ Continuous line of sight □ Close to nursing/medical staff □ Wellness Checks q 1 hr 56
  50. 50. R e c o v e r y No Force First • • • • Stop the violence Use lots of peer support Create a Healing Space Create non-hospital alternatives – Living Room, Restart, Peer Recovery Team • Change the language • Implement risk-sharing © Recovery Innovations, Inc
  51. 51. R e c o v e r y celebrate… the best is yet to come! © Recovery Innovations, Inc 58
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