An important Healthcare Safety Summit MHA held last week featured experts from throughout the state discussing not only strategies to prevent healthcare violence and conflict, but initiatives to promote wellness and resilience in a workforce that is beset by constant physical, emotional, and spiritual demands. The summit provided ideas and tools that participants could take back and use at their hospitals.
After opening remarks by Kim Hollon, president & CEO of Signature Healthcare, Bonnie Michelman, director of police, security, and outside services at Massachusetts General Hospital gave an overview of current trends and types of healthcare violence and conflict. A panel of security personnel and clinicians shared best practices to defuse and prevent harmful incidents that may often occur in an environment where patients and caregivers are under intense pressure, where patients may be suffering from substance use disorders or psychiatric issues, and where there is open access into and out of the hospital.
Some common themes that emerged during the workforce engagement panel involved ensuring that the front-line staff knows that hospital leadership has their backs. That is, when patients threaten or verbally abuse staff it should not be considered “business as usual.” The instinct to provide non-emergency care as quickly as possible may have to be overridden by the need to have a patient calm down first. Caregivers need to be supported when making such decisions and need to know that their safety is as important as patient safety.
And there must be strong documentation of violent and aggressive-behavior incidents. Often, because such activity happens frequently in care environments, the incidents aren’t noted and there’s no baseline against which to measure improvements. Hospitals are using new tools like the Collective EDie system to track prior incidents and provide a security alert so a hospital’s ED and security staff is aware of possible risks prior to interacting with a patient. This system also provides information about how providers have worked with, or provided successful de-escalation techniques to, a specific patient. An MHA workgroup is developing a workplace safety and violence prevention guidance document to serve as a framework for hospital efforts in this area.
MHA also has undertaken a Caring for the Caregiver
initiative to advance recognition, wellness, and resilience programs for caregivers. (See related peer support story below.) A panel featuring experts in this field discussed the need to empower all members of a caregiving team – including, importantly, security personnel. Michael J. Goldberg, M.D., scholar-in-residence at The Schwartz Center for Compassionate Healthcare, spoke of how hospital security should be considered consultants with an expertise in de-escalation, who can form relationships with troublesome, repeat patients and contribute to caregiving. There was also focus on applying the fourth arm of the Quadruple Aim – “Care of the Provider” – through tools such as mindfulness trainings brought to where care providers to help nourish their physical and psychological wellbeing.
Steve Walsh, MHA president & CEO, said of the summit, “We know that for our hospital workforce to provide the best care to patients our caregivers need to feel safe, appreciated, and healthy. Our summit was just one step in an ongoing process to help the people who have entered the caring professions maintain the passion and meaning that is inherent in their work – and to do their work without fear of violence.”