Presentation
Intersection of Patient Agitation and Workplace Violence: Applying Simulation and Systems Science to Address Safety and Equity in Mental Health Crises
DescriptionThe quality of psychiatric emergency care has increasingly suffered as the number of mental health-related visits to the emergency department (ED) is growing. Such visits have often been associated with poor patient outcomes, including gaps in care transitions, medication errors and disruptions, as well as suboptimal clinical processes, including longer lengths of stay, increased boarding times, and higher rates of admission, compared to non-psychiatric related ED visits. A common presenting symptom of ED visits for mental health crises is agitation, defined as excessive psychomotor activity leading to aggressive and violent behavior. An estimated 1.7 million episodes of agitation occur in EDs across the United States on an annual basis. As a result, healthcare workers face increasing safety threats from workplace violence while treating episodes of acute agitation. Unfortunately, the literature has shown that clinicians often lack formal training in agitation management despite reports of high violence exposure rates. Expert recommendations exist regarding verbal de-escalation and physical conditions when engaging this population, but implementation can be challenging in an innately dynamic work environment and during high patient census. Recent work by our team has also called to light potential implicit bias and racial differences during agitation care, which is especially important given current societal concern regarding police reform and interface with potentially agitated individuals prior to arrival in the ED.
In this presentation, an interdisciplinary panel of violence prevention, mental health, and human factors experts will facilitate a rigorous discussion of our team’s applied research using human factors and healthcare simulation techniques to address structural and systems-based barriers to safe and equitable care during the management of ED agitated patients. This includes a data-driven analysis of disease burden and structural effects on mental health crises, application of systems engineering principles to create a novel socioecological framework for agitation management, and site-wide implementation of a structured crisis response team intervention to respond to patients with high levels of agitation through simulation-based team training and stakeholder engagement.
In this presentation, an interdisciplinary panel of violence prevention, mental health, and human factors experts will facilitate a rigorous discussion of our team’s applied research using human factors and healthcare simulation techniques to address structural and systems-based barriers to safe and equitable care during the management of ED agitated patients. This includes a data-driven analysis of disease burden and structural effects on mental health crises, application of systems engineering principles to create a novel socioecological framework for agitation management, and site-wide implementation of a structured crisis response team intervention to respond to patients with high levels of agitation through simulation-based team training and stakeholder engagement.
Event Type
Oral Presentations
TimeTuesday, March 263:50pm - 4:10pm CDT
LocationSalon A-4
Simulation and Education