Implementation of a Behavioral Emergency Response Team in the Emergency Department

Emergency nurses, physicians, and patients experience occurrences of workplace violence. Having a team to respond to escalating behavioral events provides a consistent approach to reducing occurrences of workplace violence and increasing safety. The purpose of this quality improvement project was to design, implement, and evaluate the effectiveness of a behavioral emergency response team in an emergency department to reduce occurrences of workplace violence and increase the perception of safety.

A quality improvement design was used. The behavioral emergency response team protocol was created using evidenced-based protocols that have been shown to be effective in reducing the number of occurrences of workplace violence. Emergency nurses, patient support technicians, security personnel, and a behavioral assessment and referral team were trained in the behavioral emergency response team protocol. Data on occurrences of workplace violence were collected from March 2022 to November 2022. Postbehavioral emergency response team debriefings were conducted, and real-time education was provided after implementation. Survey data were collected to evaluate the emergency team members' perceptions of safety and of the effectiveness of the behavioral emergency response team protocol. Descriptive statistics were calculated.

The number of reported occurrences of workplace violence decreased by to 0 postimplementation of the behavioral emergency response team protocol. The perception of safety increased 36.5% postimplementation (mean 2.2 preimplementation, mean 3.0 postimplementation). In addition, an increase in awareness about reporting occurrences of workplace violence resulted from education and implementation of the behavioral emergency response team protocol.

Postimplementation, participants reported an increase in the perception of safety. Implementation of a behavioral emergency response team was effective in reducing assaults toward emergency department team members and increasing the perception of safety.