Emergency Departments (EDs) are seeing a rising number of visits related to behavioral emergencies. Evidence indicates that ED healthcare staff face increasing safety threats from workplace violence (WPV) while treating episodes of acute agitation. Historically, experts have often viewed Agitation and Workplace Violence (WPV) as two separate issues, with separate management and prevention strategies. A handful of researchers have begun to question this approach citing potential conflict between patient and staff safety goals within the recommended guidelines for management and prevention of acute agitation and workplace violence. In this context, Wong et al have proposed that agitation and workplace violence are
not two separate issues, but rather,
two sides of the same coin. 1In this presentation, a multi-institutional panel consisting of behavioral emergency and patient safety experts in emergency medicine, will present (i) findings from recent literature review, using a novel conceptual framework on the overlap (and conflict) between patient and staff safety goals within current best practice recommended guidelines for management and prevention of agitation and workplace violence (ii) in-depth discussion on the challenges posed by the above conflict, including
duality of “patient care paradox”, related under-reporting of WPV events, staff frustration and burnout, implicit bias contributing to disparity in outcomes including higher use of restraints among vulnerable population, etc. (iii) and finally, we will propose that instead of the traditional approach of competing staff and patient safety goals, we need to adopt a more unified, trauma-informed, systems-based approach that focuses on
improving overall (Patient & Staff) safety during management and prevention of agitation and WPV events.
This presentation will be conducted by our expert panel. During the presentation our panelists will draw from their own research, programmatic expertise, and clinical experience to provide a rigorous discussion of latest evidence and new research on management of Agitation and workplace violence, present evidence on conflicting goals for patient and staff safety and propose a novel, trauma-informed, systems-based conceptual model that will help guide future research and serve as a roadmap to help provide focus and prioritization for future research in principles of management of agitation, workplace violence, and disparity mitigation in order to create a safe setting for patients and clinicians alike.
Learning Objectives:
Analyze the factors (e.g. structural, organizational, interpersonal) that influence agitation management practices and exposure to workplace violence.
Compare and contrast the evidence of overlap (and conflict) in patient and staff safety goals within current best practice guidelines for management of agitation and workplace violence and evaluate a novel perspective about agitation and workplace violence management (they are not two separate topics, but “two sides of the same coin”).
Implement a trauma-informed, systems-based approach to local institutional guidelines that will prioritize overlapping principles of management of agitation and workplace violence to mitigate bias, disparity and improve safety for patients and clinicians alike.
