Managing disruptive patients in health care: Necessary solutions to a difficult problem

Michael J. Hodgson, David C. Mohr, David Drummond, Margaret Bell, Lynn Van Male

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: We sought to describe the components and processes in a violence risk assessment and management system, including electronic record requirements in the Veterans Health Administration (VA). We present information on system-level variation among program elements and their association with perceived and measured effectiveness. Methods: We conducted a cross-sectional survey of Chiefs of Staff (COS) at 140 VA hospitals across the United States about specific disruptive behavior program elements, such as committee processes, patient referrals, and outcome patterns. We assessed COS perceived effectiveness of the processes. We compared COS perceptions with employee-reported assault-related incident rates and workers compensation lost time claim rates for assault-related injuries for 2009 and 2010. Results: We found the violence risk assessment and management system is heavily used, often with guidance to provide police protection for providers. COS respondents were generally satisfied with design and performance of the system. Committee processes and perceptions of effectiveness were associated with reduction in assault-related incident rates. Conclusions: VA's system was considered effective by system owners and users may be effective at reducing assaulted-related injuries.

Original languageEnglish (US)
Pages (from-to)1009-1017
Number of pages9
JournalAmerican Journal of Industrial Medicine
Volume55
Issue number11
DOIs
StatePublished - Nov 2012

Fingerprint

Veterans Health
United States Department of Veterans Affairs
Risk Management
Violence
Delivery of Health Care
Workers' Compensation
Wounds and Injuries
Police
Information Systems
Referral and Consultation
Cross-Sectional Studies
Problem Behavior
Surveys and Questionnaires

Keywords

  • Accident prevention
  • Employee occupational health
  • Professional staff committees
  • Safety management
  • Veterans

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Managing disruptive patients in health care : Necessary solutions to a difficult problem. / Hodgson, Michael J.; Mohr, David C.; Drummond, David; Bell, Margaret; Van Male, Lynn.

In: American Journal of Industrial Medicine, Vol. 55, No. 11, 11.2012, p. 1009-1017.

Research output: Contribution to journalArticle

Hodgson, Michael J. ; Mohr, David C. ; Drummond, David ; Bell, Margaret ; Van Male, Lynn. / Managing disruptive patients in health care : Necessary solutions to a difficult problem. In: American Journal of Industrial Medicine. 2012 ; Vol. 55, No. 11. pp. 1009-1017.
@article{c89ad4e080714e59a1677cbda773df48,
title = "Managing disruptive patients in health care: Necessary solutions to a difficult problem",
abstract = "Background: We sought to describe the components and processes in a violence risk assessment and management system, including electronic record requirements in the Veterans Health Administration (VA). We present information on system-level variation among program elements and their association with perceived and measured effectiveness. Methods: We conducted a cross-sectional survey of Chiefs of Staff (COS) at 140 VA hospitals across the United States about specific disruptive behavior program elements, such as committee processes, patient referrals, and outcome patterns. We assessed COS perceived effectiveness of the processes. We compared COS perceptions with employee-reported assault-related incident rates and workers compensation lost time claim rates for assault-related injuries for 2009 and 2010. Results: We found the violence risk assessment and management system is heavily used, often with guidance to provide police protection for providers. COS respondents were generally satisfied with design and performance of the system. Committee processes and perceptions of effectiveness were associated with reduction in assault-related incident rates. Conclusions: VA's system was considered effective by system owners and users may be effective at reducing assaulted-related injuries.",
keywords = "Accident prevention, Employee occupational health, Professional staff committees, Safety management, Veterans",
author = "Hodgson, {Michael J.} and Mohr, {David C.} and David Drummond and Margaret Bell and {Van Male}, Lynn",
year = "2012",
month = "11",
doi = "10.1002/ajim.22104",
language = "English (US)",
volume = "55",
pages = "1009--1017",
journal = "American Journal of Industrial Medicine",
issn = "0271-3586",
publisher = "Wiley-Liss Inc.",
number = "11",

}

TY - JOUR

T1 - Managing disruptive patients in health care

T2 - Necessary solutions to a difficult problem

AU - Hodgson, Michael J.

AU - Mohr, David C.

AU - Drummond, David

AU - Bell, Margaret

AU - Van Male, Lynn

PY - 2012/11

Y1 - 2012/11

N2 - Background: We sought to describe the components and processes in a violence risk assessment and management system, including electronic record requirements in the Veterans Health Administration (VA). We present information on system-level variation among program elements and their association with perceived and measured effectiveness. Methods: We conducted a cross-sectional survey of Chiefs of Staff (COS) at 140 VA hospitals across the United States about specific disruptive behavior program elements, such as committee processes, patient referrals, and outcome patterns. We assessed COS perceived effectiveness of the processes. We compared COS perceptions with employee-reported assault-related incident rates and workers compensation lost time claim rates for assault-related injuries for 2009 and 2010. Results: We found the violence risk assessment and management system is heavily used, often with guidance to provide police protection for providers. COS respondents were generally satisfied with design and performance of the system. Committee processes and perceptions of effectiveness were associated with reduction in assault-related incident rates. Conclusions: VA's system was considered effective by system owners and users may be effective at reducing assaulted-related injuries.

AB - Background: We sought to describe the components and processes in a violence risk assessment and management system, including electronic record requirements in the Veterans Health Administration (VA). We present information on system-level variation among program elements and their association with perceived and measured effectiveness. Methods: We conducted a cross-sectional survey of Chiefs of Staff (COS) at 140 VA hospitals across the United States about specific disruptive behavior program elements, such as committee processes, patient referrals, and outcome patterns. We assessed COS perceived effectiveness of the processes. We compared COS perceptions with employee-reported assault-related incident rates and workers compensation lost time claim rates for assault-related injuries for 2009 and 2010. Results: We found the violence risk assessment and management system is heavily used, often with guidance to provide police protection for providers. COS respondents were generally satisfied with design and performance of the system. Committee processes and perceptions of effectiveness were associated with reduction in assault-related incident rates. Conclusions: VA's system was considered effective by system owners and users may be effective at reducing assaulted-related injuries.

KW - Accident prevention

KW - Employee occupational health

KW - Professional staff committees

KW - Safety management

KW - Veterans

UR - http://www.scopus.com/inward/record.url?scp=84867707082&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84867707082&partnerID=8YFLogxK

U2 - 10.1002/ajim.22104

DO - 10.1002/ajim.22104

M3 - Article

C2 - 22911609

AN - SCOPUS:84867707082

VL - 55

SP - 1009

EP - 1017

JO - American Journal of Industrial Medicine

JF - American Journal of Industrial Medicine

SN - 0271-3586

IS - 11

ER -