Improving Employee Safety Through a Comprehensive Patient Behavioral Program

• DOI: 10.1542/hpeds.2023-007714
• Publication Date: 2024-04-12T08:05:58Z
• Authors: Amanda Laprime; Rebecca Kanaley; Amy Keller; Steve J. Stephen; Jan Schriefer; Anne Fallon; Tina Sosa
• Keywords: Aggression; 03 medical and health sciences; 0302 clinical medicine; Humans; Hospitals, Pediatric; Quality Improvement; Occupational Injuries; Occupational Health

BACKGROUND Health care workers in the United States are facing increasing rates of exposure to aggressive behavior, resulting an increase employee injuries related specifically patient behavioral events. By leveraging interprofessional collaboration and system-level innovation, we aimed reduce rate events at a children’s hospital by 50% over 3-year period. METHODS An interdisciplinary quality improvement team comprising physicians, behavior analysts, nursing, other key stakeholders developed comprehensive program our hospital. The 5 pillars: aggression mitigation tools, clinical resources, advanced training, screening management, emergency response. outcome measure was reported safety This tracked via prospective time series analysis statistical process control chart using established rules detect special cause variation. RESULTS average from decreased 0.96 0.39 per 1000 adjusted patient-days, with variation observed on U-chart. has been sustained for 16 months. Staff members who experienced included nurses technicians, common antecedents including medical interventions or requests that could not be safely met. CONCLUSIONS A unified multimodal system address pediatric can foster culture inpatient setting.