How a Pennsylvania health system initiative de-escalates 75% of workplace violence incidents

Workplace violence against nurses, physicians and hospital staff continues to plague hospitals nationwide, and many healthcare employees say their organization is not doing enough to address the problem.

In 2023 alone, multiple acts of violence have happened within the walls of hospitals — ranging from shootings to acts of physical violence — and statistics show these incidents continue to rise. 

"One of the things that we had noticed, like a lot of health systems across the country, was an increase in workplace violence from patients," Kenneth Rogers, MD, told Becker's. "This was often due to agitation, and sometimes substance abuse issues or complicated medical problems. Either way, our folks were getting hurt."

Dr. Rogers is vice president and chief medical officer for the behavioral health network at York, Pa.-based WellSpan Health.

In 2019, the eight-hospital system implemented its first Behavioral Health Emergency Response Team, or BERT, a group of nurses, security and behavioral employees trained to respond to incidents of workplace violence and de-escalate the situation. Each hospital now has a dedicated team of three to four members.

"We tried as a system to figure out how we could all partner together to treat folks more aggressively on the front end to try and prevent attacks, especially for folks that are mentally ill," Dr. Rogers said. "We also wanted to make sure that employees have the skills to recognize, respond to and de-escalate situations fairly quickly on their own."

Since the beginning of 2019, there have been more than 3,500 BERT calls documented across the health system, with about 75 percent of those situations successfully de-escalated. The state's hospital association has even recognized the BERT program for improving safety across WellSpan's hospitals.

"I'm seeing BERT teams at more and more hospitals," Dr. Rogers said. "Having somebody that can respond pretty quickly with de-escalation techniques is incredibly important. That team can also help educate about how to manage the situation next time, or discuss medications that might be helpful to calm the situation."

"Even in a relatively small hospital, you can develop the outlines of a response routine. Make sure that your security staff is well trained, especially when it comes to recognition of behavioral symptoms, as having the skills to de-escalate is huge. Add bandwidth to your social work services where and when you can — someone who understands Medicaid, or is a psychiatrist or nurse practitioner — to build out teams like ours."

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