Patient tracking and proactive rounding for violence prevention

“We cannot solve our problems with the same thinking we used to create them.” Albert Einstein

In the discussion on workplace violence prevention, the combination of violent patient tracking and proactive security rounds is often overlooked. When applied well, the two tools present a highly effective mechanism to prevent violent acts as well as reassure staff of organizational support. Let us take some time to break these tools down.

Volumes can be written on violent patient tracking, but for the purposes of this discussion we are focused on any type of flagging mechanism that allows staff to be aware of either a history of violence or the risk of violence with a particular patient. I discussed this concept in more detail in my series on violence risk assessments. (See: Bed Side Risk Assessment, Part 1) The best solution is a combination of clinical bedside violence risk assessment combined with electronic flagging inside the electronic medical record (EMR). Once the potential for violence is understood, the flag serves to alert all staff to the potential risk and equip them to be safer in that environment. However, we cannot put all the responsibility for violence prevention on the clinical staff. Violence prevention is a team effort, and as such we must be able to use that flag to bring additional resources to bear to help prevent violence and protect both the staff and the patient.

Certainly, security staff must have access to be able to actively track those with a flag for violence. Knowing who may present a threat is a great step forward, but security staff have the obligation to begin active rounding on those known threats. Proactive security rounding is a twofold process that involves both regularly checking in with the staff providing care for that at-risk patient and checking in with the patient themselves. Both aspects of proactive rounding serve a purpose. First, checking in with the staff helps to keep everyone focused on the risk and violence prevention. It also serves to continually reassure the clinical staff that support is there to help them with this challenging patient, and that the organization is focused on safety. For the patient, it is an ever-present reminder of the behavioral limits that are acceptable. Additionally, it ensures there is relational development between the security staff and the at-risk patient which helps in the event de-escalation is needed.

Targeted patrolling based on identified risks is the cornerstone of a good physical security program. In a healthcare setting, that means targeted rounds with patients who have been identified as a high risk for violence. This potent combination ensures the best possible care for the patient, while simultaneously providing one of the most secure environments for the staff. It is a win-win combination.

Does your facility use violence risk assessments or patient flagging to track violence patients? How does your team incorporate at risk patients in their regular rounds? Join the conversation in the comments below, and don’t forget to like, follow and share to support the Proactive Security Blog.

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