Pilot project on reducing use of restriants and coersive methods in Estonia

Eve Pilt

Advisor for Health Board

14.12.2013

Our Pilot team on April 03,2014 in Rõngu

Contributors to the PilotEve Pilt Estonian Health Board);

Rosemary Smyth (director  Director of Standards and Quality Assurance Training and Development at Mental Health Commission Ireland );

Hanna Ahonen (Counsellor of Social Welfare at Valvira);

Thijs Melchior (Inspector IGZ elderly care Netherlands );

Marjolein van Vliet Senior programme officer, Quality and Innovation at  Care for the disabled;

Jooske Vos (EPSO)

Mari Murel ( translator Dutch – Estonian and English – Estonian)

Juta Varjas – Estonian Health Board

Inge Mäe- Estonian Medicines Agency

General goal

-To reduce and prevent unnecessary restraints

and coercive methods in the EPSO member countries, and

-If restraints or coercive methods are necessary, the use should be subject to stringent

conditions in terms of quality and safety.

Goals of the pilot project in Estonia-To test applicability of EPSO framework for monitoring and

supervisory organisations and for care providers in different settings in Estonian context

- To raise awareness on the broad definition of restraints and coersive methods

- To present alternatives - 60 alternatives for restraints in health care, Vilans 2011) – translated into Estonian and handed over to care providers

- To encourage Health Board to adopt a policy on reducing using of restraints and coersive methods

Goals of the pilot project -to accommodate differences between

approaches of the

Health Board and the Chancellor of Justice

-to send a clear message: produce jointly an optional guidelines for care providers on using restraints and coercive methods

- to draft a discussion paper on chemical

restraints

Selection of sitesAs we agreed that EPSO framework should

be applicable in all health and social care settings

we targeted to have a broad overview of various

services where using of restraints or

coersive methods is likely to happen.

Valkla HomeMarch 31, 2014 - a unit for persons with psychiatric illness placed into closed institution based on a court order. At the time of our visit the unit accomodated 93 persons.

Tartu University HospitalApril 1 2014 - intensive care department – 28 beds, nursing care department – 75 beds

April 2 2014 - psychiatric clinic – 86 beds

Rõngu HooldusravikeskusApril 03 2014, altogether 75 beds , 10 beds for nursing care and others for social welfare services

Plans for the future

- to draft a report and present it in Ireland, Dublin

- to pilot the EPSO Framework in couple of more countries

- to take reducing restraints and coercive

methods issue to a bigger audience and develop common standards for EPSO members

- To translate 80 alternatives by Vilans into EPSO member state languages

Drafting the report is in processOutline of the report:

1 – Introduction

2 – Level of awareness and Policy

3 – restraints and Coersive methods seen in the institutions

in Estonia

4 – EPSO framework useful for the Estonian Insitutions

5- EPSO framework – usefule for the Health Board

6 – EPSO Framework – useful for the Finnish Valvira

7 – Proposed Changes to the Framework

8 – Conclusions

Report will be presented at EPSO 18 –the conference in Dublin.

Thank You for Your Attention!Eve Pilt

eve.pilt@terviseamet.ee