Behavioral De-Escalation Response Team supports staff during potentially violent situations

A Milton S. Hershey Medical Center Staff Assault Workgroup, led by April Adley and Abby Rudy, vice presidents, nursing, and comprised of inpatient and outpatient nurses, physicians, security personnel and professional development leaders, developed an employee safety action plan in response to a slow and steady rise in the number of assaults on hospital staff. These assaults can occur anywhere, by patients, family members and visitors of all ages.

A key initiative in the plan is the Behavioral De-Escalation Response Guidelines policy B-44 CPM, which guides staff at Hershey Medical Center and its affiliated outpatient practices on how to activate a Behavioral De-escalation Response Team (BDRT)  to manage potentially violent situations.

Team members are trained in behavioral modification to manage potential or actual violence. Their main objective is to assist with de-escalation of potentially violent situations and offer physical and emotional support. The team consists of security, nursing leadership, a nurse resource coordinator and chaplain services.

All employees can activate the response team 24 hours a day, seven days a week by calling 8888 and stating, “activate the Behavioral De-Escalation Response Team.” The operator will ask for the location of the situation and name of the caller activating the team.

Team members identify persons in crisis who would benefit from specialized adjunctive support to maximize treatment outcomes and maintain safety. They provide a coordinated response to promote workplace safety and minimize violent patient events, and model de-escalation communication strategies for staff. Following an incident, team members work with unit leaders to complete an after-action review and use Midas reports.

Employees should never hesitate to call for the BDRT if they feel threatened or observe a threatening situation. Everyone is encouraged to read the policy.

The Hershey Medical Center Staff Assault Workgroup is highlighting additional tools, resources and trainings that have been or will be implemented for staff protection and well-being:

• In progress:
  • System-wide Cerner Oracle banner in the patient chart. Alert flags on patient chart for two years to identify previously violent patient/family members
  • A safety/assault dashboard on the Nursing Infonet page outlining the data, trends, lessons learned and best practices
• Stress First Aid: Pop up solace rooms to provide a framework to improve and recover from stressors and to foster a culture of true wellbeing–details coming soon.
• Expanded Crisis Prevention Institute training–introduction of more instructors and classes to teach safe disengagement techniques
• Additional “No Weapons” signage across campus
• Silver Sticker Program to identify safe rooms
• American Society for Risk Management toolkit, partnership with Department of Psychiatry and Behavioral Health/Pennsylvania Psychiatric Institute to train staff
• Development of dismissal process for patients with repetitive patterns of assault against staff

A safe campus is critical for staff and patient wellbeing and healing. Employees who have suggestions or feedback on staff safety initiatives should contact April Adley or Abby Rudy.

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