During the ongoing COVID-19 pandemic, patients with and without pre-existing mental health diagnoses will either be admitted to the hospital as patients under investigation for COVID-19 or patients positive for COVID-19. A safe and timely response is required for patients exhibiting escalating behaviours (e.g., responsive, agitated and/or aggressive behaviours) to prevent harm to the patient, nearby patients and staff. In this paper, we report on a new protocol that has been implemented throughout our institution to address Code White calls for escalating behaviours during the COVID-19 pandemic. This procedure uses a least restraint–based philosophy for the management of an escalating situation, involves the use of an interprofessional team of healthcare providers (including mental health clinicians) and security team members and accounts for the need for personal protective equipment. We believe that other hospitals could benefit from knowing about this approach as a strategy to improve patient care and diminish disease transmission.
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