Defusing disruption: A rapid qualitative analysis examining hospitalist experiences navigating behavioral escalation...

Area of Science:

• Healthcare Management
• Patient Safety
• Behavioral Health

Background:

• Behavioral escalation events are frequent in acute care, posing risks to patient and staff safety.
• Disruptive patient behaviors impact workplace safety and healthcare delivery.
• Limited research exists on hospitalists' practices and perspectives regarding these behaviors.

Purpose of the Study:

• To explore hospitalists' experiences with behavioral escalation events.
• To understand hospitalists' perspectives on managing disruptive behaviors in adult acute care settings.

Main Methods:

• A rapid qualitative study was conducted using virtual semi-structured focus groups.
• 27 hospital medicine participants from 19 US hospitals were involved.
• Discussions focused on experiences and response strategies for behavioral escalation.

Main Results:

• Hospitals often lack strategies for identifying at-risk patients or situations.
• Interdisciplinary collaboration is crucial but dedicated response teams are frequently unavailable.
• Inconsistent training, lack of standardized approaches, and limited proactive measures contribute to varied responses.

Conclusions:

• Behavioral escalation events significantly risk patient and staff safety and disrupt care.
• There's a need for better strategies to anticipate escalation and inconsistent interdisciplinary responses.
• Systems supporting team-based de-escalation training with bias and equity considerations are essential.