Using a Potentially Aggressive/Violent Patient Huddle to Improve Health Care Safety.

Area of Science:

• Healthcare Quality Improvement
• Patient Safety
• Workplace Violence Prevention

Background:

• Workplace violence in US healthcare settings is increasing, posing risks to staff.
• Two patient safety incidents involving violent admissions from the ED to medical units occurred at a large academic hospital.
• There is a need for enhanced safety processes for healthcare workers.

Purpose of the Study:

• To address the risk of violent patient events through a quality improvement initiative.
• To design and test a huddle handoff communication tool for patient transfers.
• To improve safety and satisfaction during patient transfers from the emergency department (ED) to medical units.

Main Methods:

• A multidisciplinary quality improvement team was formed.
• Two iterative Plan-Do-Study-Act (PDSA) cycles were used to test the Potentially Aggressive/Violent Huddle Form.
• The huddle process involved ED and admitting unit teams participating in a joint handoff call.

Main Results:

• Registered nurses (RNs) reported 100% safety during transfers with the huddle tool (vs. 54.7% baseline).
• Satisfaction with the transfer process improved in the ED from 53.3% to 75.0% between PDSA cycles.
• The huddle tool was tested across 39 patient transfers.

Conclusions:

• The huddle handoff communication tool can decrease the number and severity of violent incidents.
• Implementing this tool enhances safety for healthcare workers during patient transfers.
• This QI initiative demonstrates a potential strategy for mitigating workplace violence in healthcare.