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How One ED Reduced Violence Against Nurses

Over the last two years, the Mayo Clinic Health System in Eau Claire, WI has decreased verbal threats and physical violence in its emergency department by about 40%. Security staff have gone from spending about 350 hours a month in the ED to about 50 hours a month. Clinical staff report feeling significantly safer and better equipped to handle violence. And patient satisfaction scores have gone from the 70th percentile range nationally to the 90th percentile.

How has this ED achieved these results? In a CampusSafety podcast, Drew Neckar, the hospital's regional security director, describes his organization's approach to reducing violence, which includes:
  • Security staff educating care staff on workplace violence, how to recognize the early signs of escalating behavior, and how to defuse incidents so they don't turn into violence.
  • Behavioral health leadership educating ED nurses, technicians, and other staff on basic behavioral health diagnosis and care.
  • Embedding a behavioral health nurse within the ED to meet the needs of patients with mental health diagnoses and/or alcohol or substance abuse issues as soon as they arrive in the department.
  • Moving the role of observing patients with behavioral health diagnoses from security to care staff within the ED.

The latter strategy, with ED nurses and other staff focusing on prevention, helps decrease the need for security. This, in turn, can decrease patient anxiety, so that patients with behavioral health diagnoses feel less like they're being "watched by cops," and more like they're receiving the critical person-centered care they need. And with fewer demands on their time, the security team is better able to respond quickly if violence does erupt.

Listen to the podcast for more about how Neckar and the hospital's ED and behavioral health directors brought their departments together to achieve results.       

For more about departments working collaboratively to respond from a like approach and de-escalate situations, check out "The Conflicting Roles of Hospital Security." CPI's former director of client services, Kendra Stea, writes that when it comes to staff prevention and intervention training, "having the trainer from your behavioral health unit training alongside your security staff for the staff in the emergency department develops a wider range of application of the core concepts to a variety of situations and perspectives."   
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