The third step for Kennedy involved staff training for identifying signs of potential violence and strategies for deescalating. In the first year, health system security officers were trained. In year two, the program expanded to include ED personnel. This year, the program will include medical-surgical staff and administration.
Russell Micoli, corporate director of behavioral health services at Kennedy, says involving all the staff in deescalation training means that everybody is on the same page when a confrontation develops. "We want the person with the most appropriate relationship with the patient engaging the patient because our goal is deescalation. If the team just rushes in and there isn't someone there trying to control the flow, we are just adding to the anxiety and commotion of a situation that we are trying to calm down," he says.
"The whole idea is the arriving team takes cues from each other in what is going on, to the extent there is so much cool nonverbal communication about where people are positioning themselves and the roles people are playing that we are trying to get to the point where it's a collaborative response," Micoli says.
White says involving clinical staff in deescalation training also reinforces the notion that everybody at Kennedy has a role to play in the zero-tolerance policy.
"In the past, if there was an issue, it was, 'Call security or behavioral health. They will help us,'" White says. "Now there is much deeper understanding on the part of clinicians that they are in many cases the first line of defense in helping to prevent and manage incidents of workplace violence."