Behavioral Intervention Team to Reduce High-Risk Behaviors in the Acute Care Setting: A Quality Initiative

Area of Science:

• Healthcare Management
• Patient Safety
• Psychiatric Nursing

Background:

• Medically ill patients, particularly those with psychiatric comorbidities, often exhibit behavioral disturbances during hospitalization.
• Behaviors like restlessness or wandering can lead to adverse events such as falls, elopements, or violence.
• An interdisciplinary behavioral intervention team (BIT) was established to provide proactive behavioral health support on medical units.

Purpose of the Study:

• To evaluate the impact of an interdisciplinary behavioral intervention team (BIT) on patient safety events.
• To assess the effectiveness of BIT in managing behavioral disturbances in hospitalized medical patients.
• To determine if BIT interventions reduce the incidence of falls, elopements, violence, and other sentinel events.

Main Methods:

• A retrospective review was conducted comparing two 6-month periods: early-BIT and expanded-BIT efforts.
• Two psychiatric nurses were integrated into medical/surgical interdisciplinary teams.
• Medical records and safety reports were analyzed for patient safety events and psychotropic medication use.

Main Results:

• A significant decrease in psychotropic medication use was observed with expanded BIT efforts (71.2% vs. 61.3%, P<0.001).
• Significant reductions were noted in workplace aggression (6.7% vs. 2.3%, P<0.001) between early and expanded BIT.
• The need for security officers (4.2% vs. 0.8%, P<0.001) and restraint use (5.8% vs. 3.4%, P=0.034) also significantly decreased.

Conclusions:

• The implementation of an interdisciplinary behavioral intervention team (BIT) is feasible and effective.
• BIT significantly reduces negative patient safety outcomes, including aggression, restraint use, and security interventions.
• Integrating behavioral health support within medical units enhances overall patient safety and care.