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An Inside Look: How CPI Successfully Implements De-escalation Training in Health Care Facilities

May 2, 2022
AlGene Caraulia

The current health care climate is undeniably layered with stress and trauma. While millions of dollars are lost annually to turnover alone, those staff that do stay are reporting dramatic increases in workplace violence. One in seven health care workers do not feel safe in their current environment, while one in four nurses report being assaulted on the job.

Every day that decisions are not made for the well-being and safety of health care staff, the more people leave, the more workers’ compensation claims get filed, and the more patients’ quality of care is jeopardized.

Implementing de-escalation training into your current workplace violence initiatives can address a variety of concerns:

  • Meeting legislative requirements and industry best practices 
  • Funding source requirements
  • Decrease staff turnover rates
  • Reduce workers’ compensation claims
  • Provide staff development opportunities
  • Reduce the use of restraints
  • Facilitate a holistic culture of safety across your facility
At the end of the day, regardless of your motivation, successful implementation of training influences your facility’s culture resulting in meaningful, sustained growth.

The CPI Implementation Process

Over the course of CPI’s 40+ years of experience, we have stood side-by-side with medical leadership and administrators bringing our evidence-based approaches to their facilities. During this time, we too have learned that implementing concepts into the culture of a hospital does not happen overnight. This commitment to our own continuous learning has led to the development of our processes.

Using our specialized tools and resources in true partnership with your health care facility, the team at CPI can help in providing the foundation necessary to affect lasting changes that benefit medical leaders, nurses and doctors, administrators, and the patients in their care.

Our implementation process is designed to weave our industry-leading de-escalation and crisis prevention training content into the unique needs of your facility’s support functions.

With a clear focus on meeting short- and long-term objectives, the CPI implementation process is key to setting the stage and maximizing the return on investment of time, energy, and resources.

Let’s take a closer look.


During the Discover phase, the CPI Professional Services team will work with you to understand your goals and the motivation for pursuing CPI content. We’ll uncover how your staff work, where they find success, where they are challenged, and other factors that may impact their training.

At this stage we’ll discuss your vision for training staff, the benefits of a trained staff, and the requirements of other stakeholders for the implementation of CPI training.

Understanding what successful implementation looks like for you helps us zero in on the CPI strategy that will provide the best support and yield the results you’re looking for.

At the conclusion of Discovery, you will be able to:

  • Understand what to expect for the remainder of the implementation process.
  • Define what a successful workplace violence prevention program looks like for you.
  • Determine the skills you want your staff and larger teams to have.


Transitioning into the Diagnose phase, we will develop a specific recommendation designed to achieve the short-and long-term goals using our proprietary processes. Leveraging our experience when working with large and small, urban and rural health care facilities throughout North America, CPI will recommend specific training for each staff member within your facility using our multi-dimensional Risk Assessment.

You may have previously encountered a one-size-fits-all approach being taken when deciding what training to provide to staff. The unfortunate result of this approach is some staff being over-trained, under-trained, or receiving irrelevant information.

Our critical Diagnose stage results in specific recommendations based on data instead of emotions or current trends in violence prevention.


During the Design phase, CPI will partner with key stakeholders in your facility to develop your implementation strategy. This is where we’ll discuss technology implementation, direct delivery vs. instructor certification, communication, prioritization of training, training reinforcements, and other factors that lead to successful adoption.

Once an implementation strategy has been determined, CPI will work alongside your team to identify candidates for your Instructor Certification Program. Your CPI Certified Instructors will have a significant impact on the overall success of the CPI training program at your organization. Their organizational knowledge, attitude and professionalism will set the tone for everyone who participates in the training while serving as the “boots on the ground coach” for your staff as they apply CPI concepts.

The best CPI Instructor Candidates often have the ability to influence their colleagues while possessing these four skillsets:

  • Presentation skills: address challenges and questions in a positive manner, while directing groups through active participation exercises.
  • Availability: can the candidate commit to both the initial certification process and training their colleagues throughout the year?
  • Knowledge base: demonstrate sound judgment when faced with challenging behaviors.
  • Professional attitude: does the candidate’s overall professional attitude reflect a philosophy of respect and dignity toward the individuals in their charge?


The Deliver phase is composed of two parts.

Part One: Your CPI Instructor Certification Program (ICP).

Your ICP event will equip your designated staff members with the tools and materials necessary to deliver a CPI training program within your facility.  Grounded in interactive, experiential learning methodologies, your ICP will be led by a CPI Global Professional Instructor who possesses real-life application of CPI content in a professional environment and is held to the highest standards of performance and efficacy through their continuous professional development.

Part Two: Your End-Learners.

During Design, the training cadence, target audience, and training logistics were established to allow your Certified Instructors to focus on delivering training. CPI rounds-out the Deliver phase by setting up preparation and debriefing sessions with your Certified Instructors; supporting them on their journey as they build comfort and confidence as CPI Certified Instructors.

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On-Going Support

CPI knows that true learning is iterative. Successfully navigating the implementation process does not mean that our job is done and that you and your facility will be on your own. A designated contact within CPI will monitor your progress as you work toward your goals and help to make course corrections based on your data, while working to assure that your CPI training is more than the “flavor of the day.”

As the global leader in behavior management training, we stand with our health care partners and we genuinely believe that every health care worker, administrator, and patient is entitled to the best possible Care, Welfare, Safety, and SecuritySM.

AlGene P. Caraulia is the Vice President of Integration and Sustainability at Crisis Prevention Institute (CPI). Drawing upon his expertise in organizational behavior, program design, facilitation, and implementation, Caraulia led CPI's Training Department, Global Professional Managers and Instructors in North America, Europe and Asia. In 2018, he transitioned into his current role partnering with enterprises and focusing on the delivery of superior customer experiences to internal and external customers. Caraulia began his career at CPI as a Professional Staff Instructor and has provided Nonviolent Crisis Intervention® and related training to professionals in education, health care, mental health, human service and security/law enforcement practices across the globe.

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