Taming the Violence: An Interdisciplinary Approach

Staff at this community-based rural hospital in northwest Illinois that treats more than 18,000 emergency department (ED) patients annually and has a 13 bed inpatient psychiatric unit voiced safety concerns, leading to the organization's first shared governance project. An interdisciplinary team comprised of front-line staff, local police and representatives of the local mental health center. This team used Lean methodology to analyze the current situation, define priorities and create a workplace violence prevention program.

The program implemented mandatory training for crisis prevention and protection, the use of the Broset assessment tool to assess risk for violence, a policy to secure patients and belongings, and structural modifications to the ED environment. The team also created the role of a mental health crisis preventionist who would have a skill set that includes both psychiatric and security knowledge and expertise. The hospital utilized a variety of teaching methodologies to educate staff.

This case study is part of the Illinois Health and Hospital Association's annual Quality Excellence Achievement Awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals and health systems in continually improving and transforming health care in the state. These organizations are improving health by striving to achieve the Triple Aim—improving the patient experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of health care—and the Institute of Medicine's six aims for improvement—safe, effective, patient centered, timely, efficient, and equitable. To learn more, visit https://www.ihaqualityawards.org/javascript-ui/IHAQualityAward/