With the advent of electronic health records (EHR) came life-saving innovations in alerts, notifications and other forms of medical record flagging. One of the many innovative uses of EHR flagging capabilities is the ability to quickly identify patients with a history of violent behavior in clinical care settings. While this can improve both patient and staff safety, flags can become stigmatizing and used in punitive ways that may increase risk.

In healthcare, most violence is enacted by patients toward employees. Research shows that not only are punitive measures toward violent or disruptive patients counterproductive, they are also contraindicated due to the frequency with which they drive up risk factors and impede patient access to protective factors. Therefore, it is vital that healthcare executives charter interdisciplinary teams trained to objectively assess behavioral risk factors and protective factors and align management and safety plans with treatment plans that support patient care and services. Objective structured clinical assessments help threat management teams discern what risks the patient poses and what factors will either increase or reduce those risks. Without a trained, objective approach to threat assessment and management, interventions like record flagging may become reflexive responses to punish, label, or stigmatize patients that pose a risk of escalating tensions or creating barriers to patient care. By creating effective interdisciplinary teams, healthcare executives ensure this high-risk patient population continues to receive the care and services they need to reduce their risk of future violence.

Learning Objectives:

• Review how interdisciplinary behavioral threat assessment and management teams create safer healthcare.
• Identify key leadership processes that support medical record flagging to improve patient care.
• Discuss stigmatization of patients engaged in disruptive behavior and strategies to reduce stigmatization.

Faculty:

Kelly Vance, MD, FACHE, Director, VHA Workplace Violence Prevention Program

Scott Hutton, Ph.D., RN, FACHE, Director of Operations, VHA Workplace Violence Prevention Program

ACHE Qualifying Education Credit 

This activity is eligible for 1 ACHE Qualifying Education credit toward earning or maintaining your FACHE credential. 

Credits must be self-reported at My ACHE upon completion of this activity.