Improving Employee Safety Through a Comprehensive Patient Behavioral Program.

Area of Science:

• Healthcare Safety
• Behavioral Health
• Quality Improvement

Background:

• Rising rates of aggressive behavior towards healthcare workers.
• Increased employee injuries linked to patient behavioral events.
• Need for system-level innovation in pediatric care settings.

Purpose of the Study:

• To reduce employee injuries from patient behavioral events by 50% over 3 years.
• To implement a comprehensive behavior program in a children's hospital.
• To foster a culture of employee safety.

Main Methods:

• Interdisciplinary quality improvement team (physicians, behavior analysts, nursing).
• Developed a 5-pillar behavior program: aggression mitigation, clinical resources, advanced training, screening/management, behavior emergency response.
• Tracked employee safety events using statistical process control U-charts.

Main Results:

• Reduced employee injury rate from 0.96 to 0.39 per 1000 adjusted patient-days.
• Observed significant decrease (special cause variation) on U-chart, sustained for 16 months.
• Injuries commonly affected nurses and technicians, often preceded by unmet patient needs or medical interventions.

Conclusions:

• A unified, multimodal system effectively addresses pediatric patient behavioral events.
• This approach significantly reduces employee injuries in pediatric inpatient settings.
• Fosters a culture of enhanced employee safety.