Considering the prevalence of workplace violence in healthcare facilities, leaders at St. Louis-based SSM Health felt they could be doing more to protect employees, patients and their families.
Integrating security officers into the clinical team to prevent violence
Statistics from the Occupational Safety and Health Administration that hospital employees are more prone to injuries that lead to missed days of work than those in construction and manufacturing. While 48% of the injuries are caused by overexertion, 9% are caused by violence, according to OSHA.
Those kind of statistics spurred SSM into action. “We wanted to figure out a solution for stemming workplace violence by getting ahead of the curve because it's a national trend, and, unfortunately, we are not immune to it,” said Todd Miller, public safety and security specialist for SSM's St. Louis region, which includes eight hospitals.
The purposeful patient rounding initiative was born during a June 2017 meeting with security, behavioral health and emergency department staff along with executive leadership from roughly 20 SSM hospitals across four states. The initiative encourages security guards to be a more integrated part of the care team, actively communicating with patients and clinical staff on hospital units so they can get a better sense of situations that could be potentially violent and intervene before they escalate.
“The role of our security officers has changed now with much more emphasis on being another facet of the care team,” Miller said.
Prior to the initiative, which was rolled out across the system last June, security guards walked the units of hospitals but didn't proactively communicate with staff or patients. Guards typically only intervened when they were called by staff in already violent or disruptive incidents.
StrategiesEnsure all security officers have crisis prevention training.
Build a schedule for security officers to round frequently on patient units.
Encourage officers to build a rapport with clinical staff in order to help spot potential violence.
“We were taking what they were traditionally doing and trying to bring a bigger value,” Miller said.
Security officer managers at the hospitals communicated the initiative to the guards and clinical staff. The security officers already have crisis prevention training, but they were encouraged to better use some of the training principles like building rapport with clinicians, patients and families and spotting potentially aggressive behavior before it escalates.
SSM declined to disclose how many security guards they employ for safety reasons, but they haven't had to hire more staff because of the initiative.
Under the new program, the officers round on each unit of the hospital at least once a day, speaking to nurses and other clinical staff about any concerns they may have about patients or their families. If a nurse brings up anything, the officer then speaks one-on-one with the patient and family to find out what may be wrong and how it can be addressed. To break the ice, officers are encouraged to ask if they need anything, even if it's just a cup of coffee, Miller said.
The benefits of the approach can be felt across the clinical units. Kate Madden, nurse team leader of the neonatal intensive-care unit at SSM Health Cardinal Glennon Children's Hospital in St. Louis, said the initiative allows NICU nurses to do their jobs better.
The NICU at Cardinal Glennon has 65 beds and is designated as Level 4, the category that provides the most complex acute care for infants. The nurses are usually dealing with emotionally distressed parents and families on top of their intense clinical duties. The extra support from the security guards to handle stressed families “helps the nurse focus on (patient monitoring) and the other things she is responsible for and expert at,” Madden said.
Since the initiative was implemented last summer, violent incident reports have decreased, in one case by more than half, Miller said. Before the initiative at one SSM hospital, which Miller declined to name for security reasons, the four-month average of calls to security for a disruptive patient was just over 34. After the initiative, the four-month average dropped to less than 16.
“That's a good indicator to our team that what we are doing has value and is working,” Miller said.
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