SCCM Resource Library-Keeping Your Employees Safe by Putting the Cuffs on Workplace Violence

Video Transcription

Hello, I'm Patrick Aguilar, and it's my pleasure to welcome you to the Society of Critical  Care Medicine session on keeping your employees safe by putting the cuffs on workplace violence. Currently, I'm the Chief Medical Officer at a healthcare venture in Tulsa, Oklahoma.  Prior to this, I was the Director of Medical Critical Care at Barnes-Jewish Hospital in St. Louis.  In that role, I came across many times where patients and their families and our staff came into conflict.  Unfortunately, some of those conflicts ended up being physical and resulting in injuries.  According to the Occupational Safety and Health Administration, healthcare employees overall  are four times more likely to be injured by violence than the private industry as a whole. At the same time, the Bureau of Labor Statistics reports that up to 15% of all injuries on  the job for nurses occur because of some element of violence. We know that some of our patients are confused or not in their state of mind to understand  what's going on, but we also know that there are times where that's not true, where patients  are acting out because of issues with personality or because of problems that can be prevented.  It is the responsibility of every healthcare organization to ensure the safety of its employees  because without safe environments to work, the employees may choose other places to work and at the same time may provide less standard care than what we would all like.  This is a really important issue. It's an issue that affects the psychology and the wellbeing of everyone in the hospital, including the patients.  I'm really excited for the presentations that are going to be delivered in the course of this session where we'll explore some really important ways to prevent workplace violence  and handle its impact. First, we're going to talk about policy and approaches that can implicate all the people  in the system to try to help rally around prevention of workplace violence. That session, setting the mood for workplace violence changes within a hospital system,  we'll go through some avenues of approach that can really make a big difference for hospital systems, both small and large.  The next session, They Hurt Us, We Hurt Them, and We All Hurt Each Other, we'll review the  concepts that I was talking about just a second ago, the idea that if I feel like I have an unsafe place to work, I'm not going to bring my best self.  We know from work by behavioral economists and cognitive psychologists that in moments of threat, our cognitive efforts are impaired and our ability to process is not as good  as we would like. I'm excited to hear what the speaker has to say about how we can all recognize the  impact that violent events, whether verbal or physical, can have on us and how we can act together to try to overcome the response that we might otherwise have.  Finally, Knowing Who Does What, Successful Implementation of Workplace Violence Algorithms in the MICU, we'll talk about what it takes to create role clarity around the prevention  of workplace violence and the promotion of safe environments of care. This is really important. We know it's important because our staff depends on it.  We know it's important because our patient care depends on it, and I'm very excited for what the speakers have to say.  So thank you for the opportunity to introduce this session, and with that, I will turn it over to them. Hello, everyone.  My name is Lynn Schallum, and I'm the Director of Research for Patient Care Services at Barnes Jewish Hospital at Washington University, and I'm very honored to be on the panel to  discuss workplace violence prevention. The topic for my presentation will be setting the mood for workplace violence prevention within the hospital system.  I will take an organizational approach to preventing workplace violence. I have no disclosures. I'm going to start with an overview of the BJC health system.  We are 13 hospitals across urban and rural settings in eastern Missouri and western Illinois.  As I said, I'm at the academic campus, which includes Barnes Jewish Hospital and St. Louis Children's Hospital at Washington University Medical Center.  We have several initiatives that are at the system level, including a Center for Clinical  Excellence, a Critical Care Collaborative, a System Collaborative for Practice Counsel,  and in 2019, they expanded the Workplace Violence Prevention Team to expand to all of the facilities, and that occurred in 2019, and that's when I joined the group.  In terms of Barnes Jewish Hospital, I wanted to give you a feel for the size of our facility.  We have over 9,000 employees, including over almost 4,000 registered nurses, almost 1,700 attending physicians, over 800 residents and fellows.  We have 1,200 staffed beds with over 53,000 inpatient admissions, so you can imagine the  risk that we have for workplace violence from our patients just to the sheer volume of inpatient  admissions, as well as outpatient visits, and then all of our access points across our campus that allow for community members to enter the facility.  So I'm going to start with a review of the literature. There really isn't that much in terms of organizational interventions.  There was a Cochran Review published this year in 2020 that examined the effectiveness of interventions to prevent and minimize aggression towards healthcare workers, and the focus  was organizationally, in terms of programs, policies, and work practices. They found only seven studies that were reviewed through May of 2019, four conducted in nursing  homes, two in mental health inpatient settings, and one in ED, so notably, there are none in the acute care settings.  Most of the studies found no impact on the interventions, and the one intervention that showed some improvement was conducted in a mental health setting, and they found that  by conducting regular risk assessments for aggressive behavior that they did show a reduction in aggression. However, the quality of evidence was graded as low quality.  However, we do know from the literature that workplace violence is very prevalent in healthcare.  A survey by the American Nurses Association in 2014 found that 43% of nurses and nursing  students reported being verbally and or physically threatened by a patient or family member of the patient, and 24% of them reported being actually physically assaulted by a patient  or family member, and they noted that organizations contribute to the large complexity of workplace  violence in terms of failing to take action when it is warranted to address either incivility, bullying, or workplace violence.  So organizations definitely take a role in improving the preventive measures for workplace violence.  In addition, the Joint Commission's Sentinel Event Alert, which was updated in 2019, has a lot of important information for us to consider.  This quote is actually from the General Accounting, the Governmental Accountability Office that was reported in the Sentinel Event Alert, and it stated that healthcare facilities  experience substantially higher estimated rates of non-fatal injury due to workplace violence compared to workers of other workplaces.  There were 365 reports from 2010 to 2018 of either assault, rape, or homicide in healthcare, and they noted that there's significant underreporting.  The Joint Commission estimates that up to 70% of violent incidents are not reported. While Ulrich et al., which examined the healthy work environment of the American Association  of Critical Care Nurses, they conducted a survey that was published in 2014, and they found similarly that 40% of nurses did not report a negative incident.  The Joint Commission identified several contributing causal factors, failures in staff supervision,  incompetent assessment, staffing levels, as well as complacency, problems with compliance with policies and procedures, and just the organizational culture in general, lack of  communication among staff, patient assessment. We know that our mental health patients are cared for throughout the organization and  not just on mental health divisions, that they're cared for in acute medicine, surgery, et cetera, and a lack of patient observation.  And then, of course, there's the competing priority. We have to find that balance between maintaining security for our staff while still assuring customer satisfaction.  So these are the organizational priorities delineated by the Joint Commission as well  as the CDC, the National Institute for Occupational Health and Safety, and they include leadership,  commitment to safe environment, accurate reporting, a communication process, assessing for risk,  a multi-pronged and multi-professional education, policies and procedures, and staff support. In addition, we know that healthcare worker burnout, workplace violence contributes to  workplace violence burnout with extended exposure. So we have to do something about it. At BJC, one of our values in 2020 that was added was safety, that we are committed to  keeping our employees safe. And some of the behaviors that our staff should expect is that we create a physically and  psychologically safe environment as well as responding in a just and accountable manner to risky or unacceptable behaviors. So it starts with that organizational commitment.  We also then need to develop goals, and the goals that we set were to reduce the number of workplace violence events.  However, as we have provided education and discussed our commitment, we know now that actually our workplace violence events have increased because of the increased reporting  and because of the awareness of what all entails workplace violence. We also want to reduce the severity of workplace violence events.  We may not be able to prevent all of them, but we want to reduce the severity. And we want to increase workplace violence drills as we hope they become, events become  less and less frequent, that by having drills, staff will continue to be able to respond immediately and effectively. So zero tolerance.  Again, a study by Ulrich et al. in the survey that was published in 2019, nurses that were at organizations with zero tolerance policies against both verbal and physical abuse did  report fewer negative incidents than those who reported no zero tolerance policy. And on the right, you can see the signs that were created in 2019 and started being posted  in 2020 across our facilities that we want to encourage the positive behaviors, help us provide a safe and healing environment, and that we are not going to tolerate violence,  acts of physical assault, intimidation, threats, et cetera, and that anybody can report those to the public safety department.  However, it's really hard to say that we have a zero tolerance policy, because what does that really mean?  We know that there are, one of the reasons that workplace violence is higher at healthcare institutions is that our patients experience chronic processes such as mental illness,  dementia, traumatic brain injuries, as well as acute processes. So our zero tolerance is related to how do we respond?  We need to have consistency in the way we respond to any of these violent events, and that will then build the trust.  And again, as I said, one of our goals is to minimize the severity of the workplace violence episodes. And that's how we view zero tolerance.  So as a system, we did commit several resources, leaders at both the system and local level are committed to this work and to reducing workplace violence, and it is inclusive of  various disciplines. Definitely we need the input of occupational health as they do the reporting to OSHA and monitoring of the staff who are involved in the incidents.  Public safety is an integral part, and they have that communication with local law enforcement as well.  Legal and risk management, our behavioral health experts, again, we see many behavioral health patients outside of behavioral health settings, so their input is greatly appreciated.  We need to hear from clinicians from various departments as well as staff from departments that may not be considered patient facing, but they really are.  Our individuals and our guest and patient relations and registration in our cafeteria that are exposed to workplace violence as well.  Our providers are key team partners, both the physicians and the advanced practice providers. Patient experience, I said earlier that we need to have that balancing between patient  satisfaction and staff safety, and so we've included our patient experience as well as seeking input from our patient and family advisory councils.  The Center for Diversity and Cultural Competency is important to understand what may be triggers with various cultures and try to avoid them.  Our clinical information system analysts, and when it comes to our inpatient areas, our clinical nurse specialists and educators on the divisions are really key to getting  the education. So as a system level, you really need to decide what is the system work versus what is the local work. What needs to be standardized?  We have, as you saw, a variety of rural and urban facilities, and things are going to be different in different communities. So what's the academic versus the community efforts?  What work could be pilot work that would be more specific to, example, the pediatric institution?  My answer would be what needs to be standardized includes those policies and procedures, starting  with that commitment by all of the leaders and all of the workers to protect each other, as well as the policy procedures that flow from them, which includes the reporting system.  So we need to get to the reporting system. We really need to understand the extent of the prevalence of workplace violence.  And so first we need good data that can be viewed by all, categorized, systematically reviewed, to allow us to understand that data.  And then we have to accept the problem and know that not all of it is preventable, but what can we do to reduce it? And again, that commitment by everyone to safety.  In terms of education, there are many components that should be included. And as I state on here, violence is not the fault of the victim.  And so while we provide education, we want to have that as the underlying theme. We are providing you some tools and resources to reduce your harm.  But if you are involved in a workplace violence event, it does not mean that you are at fault.  Some of the components that should be included are conflict management and how to deal when things are escalating, therapeutic or relational communication.  Our speaker on that really hones in on getting to that thing below the thing. What is the patient or family really upset about?  Have they not been able to visit for a variety of reasons? In critical care, we are doing all these procedures and they may not be able to come visit.  Certainly, during COVID, we've had extremes where no visitors were allowed, even to patients who did not have COVID.  So there's a variety of reasons that patients may get upset and visitors also get upset. So we need to understand what they're really upset about.  And then to have early recognition when a patient or a family member is escalating and to provide that de-escalation training.  We use scenario-based simulation training, which includes public safety involvement, which was really key for the bedside clinicians to hear from the public safety of how they  address things and for public safety to see what some of the risks were that bedside clinicians were facing.  I'm not endorsing, but we do use Crisis Prevention Institute, which is an international training  organization and they use verbal intervention, nonviolent crisis intervention, and advanced physical skills.  So in this training, staff are able to actually get out of holds, for example, when somebody is grabbed. And then they also help to recognize the threat and how to respond.  In terms of scenario-based training, Brown et al. found that with the use of four scenarios that were five minutes in length, followed by a debrief, the participants perceived that  they were more prepared. And we have found that in our training as well. Donna Prentice, Dr. Prentice will be speaking shortly about our actual local approach and  some of the training that we've done. And it's just key that staff feel prepared, like with any skill, they need to develop these skills. So not all of it can be online education.  You have to actually have some hands-on education. Communication, as was mentioned previously, is very important. And that includes multiple aspects.  So in the moment, how are you going to communicate to get help? How are you going to communicate so that others are aware if you step out, nobody else steps  in while that patient or family member is aggressive and you're trying to get help? So there needs to be communication in the moment. You need communication from shift to shift.  I think one of the biggest concerns we have as healthcare providers is not labeling the patient or the family because it could be an acute process or a short term.  We don't want to label them as aggressive, but we need to ensure that there's safety. So we do need to have ongoing shift to shift communication while that patient is at risk  for displaying or having aggressive behaviors. We need to have a process of communication in the medical record, right, in the electronic health record.  So who's going to document there, where they're going to document, is there going to be chart flagging?  Many healthcare facilities use chart flagging, and that's something we're still discussing and working out.  But as we're discussing it and developing the policy around it, you need to think of things like who can activate it, who can deactivate it, how often is it reviewed, is it going  to go only across inpatient, or is it going to go across all encounters? And then how will local law enforcement be engaged?  And as I said earlier, it may look different at different facilities because you have different local law enforcement.  But there needs to be a process to allow for staff to charge, if they so choose, to charge an individual with a crime.  Fundamental to all of that is support of the employees. I've said it before, and I'll say it again. We need to have leader and organizational support of all staff.  That comes from occupational health in terms of follow-up, as well as follow-up of patients and families that may have been involved.  We have a program called We Care, and it evolved from the work of second victims by Dr. Sue Scott at the University of Missouri, and they call it the 4U team.  And the second victim is, for example, a clinician who is involved in an unexpected or traumatic clinical experience, and that includes workplace violence.  So when a workplace violence event is reported, a member of the We Care team contacts that employee and provides any support and follow-up.  And it's really beneficial to hear from a colleague to get that support is what we found. And then ongoing support.  With compassion, fatigue, and resiliency education, we provide ongoing support to help again prevent that burnout and in the high stress environment that we live in  and in managing workplace violence exposures. The organization needs to have ongoing communication  with all employees. What we're doing to keep you safe, how we're doing, what we're continuing to  try to get feedback. We learned a lot in this process from hearing from frontline staff that  completed reports and those that didn't to hear what they were going through and then explore  other options like the role of sitters using tele ICU for example when acute event is occurring and  you need to leave the room or electronic observation with to replace sitters. So a variety of approaches need to be used to support our employees. Policies and procedures the final  thing but the comprehensive again I've talked about a lot of these things but all of these  processes need to be included in terms of who's going to do what and made known to all of the  staff that these are our policies and procedures. So in conclusion, in order to have a healthy  productive and joyful work environment we need to as an organization and as leaders to provide that environment that allows that for them to feel safe and to feel trusted that  should they encounter workplace violence that they will be cared for and that we as an organization  through education and policies and procedures communication processes that we are creating an  organization of safety. So I thank you for your attention and I look forward to our panel  discussion at SCCM Congress. Thank you very much. Hi I'm Donna Prentice. I'm a research scientist  at Barnes-Jewish Hospital and for the next few minutes I'm going to share with you our pilot for  implementing algorithms for workplace violence prevention in the medicine intensive care unit.  I do not have any financial disclosures. So our story begins back when the staff were telling us  that they were seeing a lot of uncertainty. They didn't know how they were supposed to respond to  workplace violence incidents and so for the purpose of this talk workplace violence is  going to be patient or visitor or family violence against staff and staff were telling us that they  just didn't know how they were supposed to respond. They were feeling sometimes abandoned by leaders because sometimes the leaders would use a verbal abuse as an opportunity  for service recovery and that made the staff feel abandoned and left alone. Leaders were also  telling us that they didn't really know what they were supposed to do in an episode of workplace  violence and when that was being echoed by the providers. So part of our the process began with  the evidence-based practice committee. So in 2019 the committee wanted to use workplace violence  as their project and every year the committee would choose a project. We dive into the evidence  and we implement an evidence-based practice. So my co-chair and I went to the other hospital  committees that were working on workplace violence and there were two and we were looking at what  they were doing and we found gaps where there wasn't anybody working on clinician or leadership  response and so that's where we decided to focus the committee. So our goal was to bring consistency and response based on the evidence and improve the safety of our staff nurses.  After we had developed our processes we realized that we needed to train to implement our pilot  and our training included definitions, classes such as crisis prevention intervention,  therapeutic communication, assessment for risk of aggression, as well as the response algorithm and I'll go into each of these things in more detail.  So it was also very comforting for the staff nurses when they saw the hospital policy for workplace violence management and that they could see as I have outlined here in the red  that there was clear definitions of what was unacceptable behavior and that those actions  towards staff were not considered okay. So that was the first step in helping the staff feel supported. The other thing we found that we needed was consistency in reporting events  because if we don't have that then we don't understand the breadth and the depth of the problem and what we under uncovered was that staff in some areas were using the incident  reporting system which was designed for patient safety incidences. So while the patient might  have been involved in the aggressor toward the staff it really wasn't a patient incident.  So all of those reports they were submitting were going nowhere. They weren't being counted, they weren't being collated and we needed to rectify that. So they determined that the  repository for the workplace violence data was going to be the occupational health department  and so we wanted to use the occupational health reporting system. Now staff were somewhat familiar  with this because that's how they reported things like a needle stick injury or if they had an  employee injury at work but we wanted them to use this for all workplace violence including verbal.  So we had to train the occupational health department to expect it and we had to train the nurses on how to use this reporting mechanism. We added an icon to all the computers  to make it easy for the staff to get to this reporting system. In addition the reporting  system auto populated a lot of information once the staff put in their name and employee number.  So when we looked at the evidence for education for staff we found a lot of evidence to support  the crisis prevention intervention training program also known as CPI. So we wanted that to be the baseline education program for the staff and so the decision was made that all  staff would undergo the CPI training. CPI training included de-escalation techniques, it included training the staff to be observant of their environment so that they're not trapped  without an exit in a situation, how to get out of holds and grabs in case they found themselves in  that unfortunate situation. In addition we supplemented that training with hands-on scenario  based training that reviewed each step of the algorithm. We have three levels of responses.  We made these case scenarios as realistic as we could with actors, staff performing the role of  patients and visitors and families. Short of harming the staff these were about as realistic  as we could make them. The other gap in education we uncovered was that staff really weren't trained  in therapeutic communication. We were fortunate that we had an in-house expert. He was a manager  in the psychiatry division and he was agreeable to teach the class and allow us to video him. So we used his video afterwards to in the subsequent training episodes and all staff  were required to review the module and we were able to put it in our learning platform and continue to use. Now we also wanted in a method to be able to maybe predict a patient  who had not been aggressive or violent yet but to know that they may have that tendency just so that staff have a little bit of a heads up before they enter a room.  Unfortunately what we found is there was no single user-friendly standard assessment tool that could  predict violence across the continuum of the hospital. There were validated tools in psych  such as the BROSAT, there were validated tools in the emergency department and there were validated  tools for the med-surg unit and of course none of those were the same. So since we were working  at med-surg inpatients, we went with the aggressive behavior risk assessment tool or the  ABRAT which was validated in that environment. It's also since been validated in long-term care.  What is also nice is the hospital could get permission to use this and there was no cost  to the organization. If you're not familiar with the ABRAT, it has 10 categories that it assesses and if two or more of those categories are positive, then the patient has a risk of  becoming violent or aggressive. We wanted to keep it as simple as we possibly could for the nurses  and so we looked at what they were already documenting and we used the EPIC charting and once a shift they're doing a psychosocial assessment on the patient and a lot of the  elements of the ABRAT were already there and so we worked with our EPIC IT people to add a few of  the additional things that were missing from the ABRAT to add a line item that said ABRAT score  and then they worked their magic behind the scenes to make it where the computer would calculate the  ABRAT score and if two or more of the categories were positive, their row label would say ABRAT  score positive or negative if that was the case. We also wanted to send that information to the  clinical summary pages where the providers or ancillary personnel might be reviewing a chart  in addition to other nurses and so you can see from the red rectangle and the red arrow that  this particular person ABRAT score is negative but we wanted to not make it any harder than it  needed to be and we didn't want the nurse to have to go to an additional site and create additional  flow sheet to get this ABRAT score. We wanted to incorporate it into the already processes.  So now to the algorithms. We developed two algorithms, one for clinical response and one for a leader response. The algorithms had three levels of responses. Level three which was  escalating behavior but no actual verbal or physical violence. Level two which was verbal  abuse. Level one which was physical abuse. So here's an example of what our bedside clinician  algorithm looked like and as we develop these algorithms you can see that this one is on draft  13 and we put them under all of our stakeholders noses. We wanted them to look at it to provide us  input what we needed to improve and it is still I will say a work in progress and I expect it to  continue to change as we're continuing to pilot it on different areas. So it reminds the clinician to  call security immediately if there's an immediate threat. It also in the top part of the algorithm  with the green ovals it reminds them to use their therapeutic communication their de-escalation  techniques to try to intervene in an episode where there is not yet verbal or physical abuse.  If there's verbal or physical abuse they jump right down into the lower part of the algorithm  and use that category. A level three even though there's no physical or verbal abuse yet it's a situation where the staff have used their therapeutic communication and it's just not  resolving the situation. That's where the staff let their leadership know they need to circle the  wagons they need to look in depth and see what they can do to address the situation so that it  doesn't become a verbal or a physical abuse situation and what could be done to resolve that.  The level two or the verbal abuse sadly we found from providers and nurses and other clinicians  that they just said we just thought that's part of the job that we just have to tolerate that  and we were like no you don't tolerate verbal abuse and so we had to work through that had  been just so ingrained in the staff that I don't even think they recognized how much they were  dealing with that and so we're trying to change that culture. And then level one is the physical  abuse and notice the first action that the nurse does across all three levels is to loop in their  leadership so that leadership can come and support their processes and come alongside them.  The back of the algorithm provides more detail to dovetail to the front. We wanted the front  the down and dirty bullet point type of process. The leadership algorithm mirrors the clinician  algorithm and has the three levels of response and it tells the unit leadership what they should  do because remember the leaders were telling us they didn't really understand what they should do so it guides them on pulling the team together and who should be part of that team  as well as how they should support that staff nurse whether or not it's changing assignments  or providing patient care while the staff nurse sits down and has time to fill out the occupational  health report or enter the epic note. And they also have a back of an algorithm that supplements  the front and gives more detail. For example in the level three response you can see that they're  to arrange the patient care huddle but 30 minutes to an hour from now. Where a level two which is  the verbal abuse we want to see that happen a little more quickly within say 30 minutes  and the level one response which is the physical abuse we want that ASAP and we also want to make  sure we're looping in the attending physician at that point in time. Now we are a training facility  so we do have interns and residents and fellows but we want to make sure the attending is aware  of all physical abuse. We also develop paperwork to support the process. The left side of this  is the front part of the sheet the right side is the back but it's a place where when they do that  patient care huddle when the clinician the leader the intent the provider and anybody else that can  contribute to that situation like the social worker pastoral care the pharmacist they come  together and they look at what's causing the problem they look at how we're going to address  it what the behavioral treatment plan is and then the leader and the provider and if necessary  security reviews that treatment plan with the patient visitor our family. This stays at the  bedside and the nurse will then use that and shift to shift report so that the approach to the patient  and the family can be consistent. Now this was a pre-post program evaluation and we did learn from  our survey some positive things and some things we needed to change. We did see that their training had  been completed and that we did learn though that there were less nurses that completed the post  survey than the pre-survey but we did find that the staff were telling us that they had improved  confidence and their ability to respond to violence. Now the rest of the questions really  didn't have a significant change to them but there were some that did have a trend toward higher  scores such as they felt like they had better leader support that they were dealing better with  the physically aggressive patient or visitor and that there was some acceptance with some annual  competency. Some other positives from the pilot that obviously a team approach is a good idea  and that they really really like the scenarios that went with the algorithms they found them to  be very useful and they really wanted more practice with that so that's something we're thinking about that maybe that should be a quarterly refresher and that they wanted more  examples from the leader versus staff response and they felt like our algorithms were useful and that  they provided guidance where they hadn't had any before. Now they did tell us that our initial  therapeutic communication video was good information but too long so we re-videoed our expert  and we trimmed 30 minutes off of the original video and now that is what is in our training modules.  Some other thoughts is they nobody wants to label the patient as bad and do we really use the  algorithms when we know we maybe have some organic brain conditions going on. We didn't always have  the best physician involvement during our pilot and especially on the floors there's not always a  willingness to discharge the patient and they wanted to make sure that we understood that the  algorithms didn't deter the bad behavior and we didn't expect that but we wanted to provide  consistency to response. They felt like they still needed some stronger zero tolerance and I think  you heard from Lynn that the hospital has put up some signage that will help support that and that  they also needed an easier way to communicate between other staff and other members of the team.  The MICU for example has writes the patient's goals for the day and the plan on their glass  doors outside each room so they choose to do P for patient, V for visitor and put their level  on the door like it could be a P1 or a P2 or a V2 and so everybody that knew in that room  had a clue of what level of aggression that the patient was if they had any. However that's not  going to work on the patient floor because they don't have the glass doors and don't write the  plan of care so we need to think through how that communication is going to look because we don't want an x-ray tech to walk in the room and be injured or be in an unsafe situation.  So from some final thoughts our next steps we're doing a second pilot in our surgical burn trauma  ICU. We're right at the point where we're going to do our post data collection. We really are  anxious to see this because there's strong physician support of this process in the surgical  intensive care unit where we really didn't have that in the medicine intensive care unit.  So we're anxious to see how that will help. We've implemented the things we learned from the MICU  pilot so we're hoping that we are achieving our goal and keeping our staff safe and having consistency in response. So thank you. I look forward to your questions.

Video Summary

In this video, the speakers discuss the importance of preventing workplace violence in healthcare settings. They highlight the high rates of violence against healthcare employees and the impact it has on staff well-being and patient care. The speakers emphasize the need for healthcare organizations to prioritize the safety of their employees and provide a safe working environment. They discuss various approaches to preventing workplace violence, including policy and approach changes, training in conflict management and therapeutic communication, and the implementation of workplace violence algorithms. The algorithms provide guidelines for responding to workplace violence incidents at different levels of severity, such as verbal abuse and physical assault. They also stress the importance of consistent reporting and communication among staff, as well as support and resources for employees who have experienced workplace violence. The speakers acknowledge the ongoing nature of their work in developing and refining these preventative measures, and they share the positive feedback and results they have received from their pilot implementations. Overall, the speakers emphasize the need for a coordinated and multi-faceted approach to preventing workplace violence in healthcare settings.

Asset Subtitle

Administration, Professional Development and Education, 2021

Asset Caption

The Society of Critical Care Medicine's Critical Care Congress features internationally renowned faculty and content sessions highlighting the most up-to-date, evidence-based developments in critical care medicine. This is a presentation from the 2021 Critical Care Congress held virtually from January 31-February 12, 2021.

Learning Objectives

Interpret hospital system politics regarding managing workplace violence
Identify the most common types of workplace violence in the ICU setting
Develop a step-by-step approach to institute a bedside clinician and leader workplace violence response algorithm

Setting the Mood for Workplace Violence Changes Within a Hospital System
Marilyn Schallom

Knowing Who Does What: Successful Implementation of Workplace Violence Algorithm in the MICU
Donna Prentice

Meta Tag

Content Type Presentation

Knowledge Area Administration

Knowledge Area Professional Development and Education

Knowledge Level Foundational

Knowledge Level Intermediate

Knowledge Level Advanced

Membership Level Select

Tag Staffing

Tag Medical Legal Issues

Tag Simulation

Year 2021

Keywords

workplace violence

healthcare settings

violence prevention

employee safety

safe working environment

preventing workplace violence

workplace violence algorithms

	Society of Critical Care Medicine 500 Midway Drive Mount Prospect, IL 60056 USA Phone: +1 847 827-6888 Fax: +1 847 439-7226 Email: support@sccm.org	Contact Us About SCCM Newsroom Advertising & Sponsorship DONATE	MySCCM LearnICU Patients & Families Surviving Sepsis Campaign Critical Care Societies Collaborative	GET OUR NEWSLETTER
© Society of Critical Care Medicine. All rights reserved. \| Privacy Statement \| Terms & Conditions The Society of Critical Care Medicine, SCCM, and Critical Care Congress are registered trademarks of the Society of Critical Care Medicine.