Department of Psychiatry
School of Medicine Queen's University

Research and Scholarship

Current Research and Program Development/Evaluation:

Inpatient Safety

a. Grading Risk of Inpatient Threat (GRIT)

GRIT is an assessment, communication, and risk management system for the imminent (within 24 hours) risk of inpatient violence.  It has been designed for use on the Forensic Services Inpatient Unit at Providence Care, based on current research on imminent risk for violence, practices at other forensic facilities, and current legislative requirements.  GRIT will shortly be pilot tested on Forensic Services; an adapted version of the GRIT system will later be implemented on other inpatient units at Providence Care Mental Health Services.  The GRIT system will be formally evaluated for effectiveness in reduction of inpatient violence.  In addition, data from the project may be combined with data from similar implementations at other forensic sites, as part of a larger scale multi-site research project.

Project Lead/Primary Investigator: Dr. Rebecca Douglas
Collaborators: Kim Knight, RN; Dr. Tariq Hassan

b. SAFEWARDS implemented on forensic units to improve inpatient safety

The Safewards Model outlines ‘originating domains’ that can give rise to certain ‘flashpoints’ that can trigger an incident or ‘conflict’. Conflict is defined as any action or behaviour that can threaten the safety of a patient and those around them. Another main component of Safewards is ‘containment’—actions that staff must take in order to eliminate or reduce conflict.

Originating domains are those six broad aspects that affect a patient’s well-being: patient community, patient characteristics, the regulatory framework, the staff team, the physical environment, and factors outside of the hospital (i.e., visitors). The flashpoints are social situations or behaviours or ways of thinking arising from those originating domains that can trigger a conflict.