The Utilization of Empathy and Self-awareness Models to Deescalate Violence in the Ambulatory Clinic Setting

Our objective was to understand how empathy and self-awareness content, alongside traditional deescalation training, might impact ambulatory clinic staff responses to patient and family escalation events. Verbal and physical workplace violence is escalating across healthcare organizations, including ambulatory clinics. Deescalation content is often developed with acute care, psychiatric, or emergency care in mind. There is a need for relevant and empathic deescalation training for ambulatory clinic staff to address their specific needs. We developed empathic and self-reflective deescalation training which was interactive and relevant to ambulatory clinic staff. Staff were trained using both in-person and virtual modalities. Participant self-reflection pre- and postintervention questionnaires indicated increases in understanding and application of deescalation methodologies. Multiple ambulatory clinics where staff participated saw a decrease in patient complaints and grievances. Participating ambulatory clinics also saw an improvement in the likelihood to recommend practice. However, participating ambulatory clinics did not see a reduction in reported patient-involved workplace violence events. Ensuring both empathy and self-awareness content in deescalation training, along with relevant ambulatory clinic scenarios, support ambulatory staff to respond effectively and appropriately to escalation events, helps reduce patient complaints, and improves patient satisfaction.