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p h i l a m e d s o c .org FEATURE "LIFEGUARD" DEVELOPS CLINICALLY INFORMED TRIAGE By: Marcia A. Lammando, RN, BSN, MHSA The heightened awareness of behaviors that may negatively impact the culture of safety has led to health care organization development of internal processes to actively address these workplace concerns. These issues that run the gamut of dealing with colleagues whose behaviors and habits, such as repeated outbursts of anger directed at patients and co-workers, bullying, micromanaging and acting entitled, to name a few, disrupt workflow. development of a behavioral assessment approach coined as "clinically informed triage." As the word triage suggests, this assessment process allows for a methodology to quickly analyze and dissect the circumstances leading to and contributing to the unprofessional behavior and provide a directive for change. Suggestions for remediation following clinically informed triage may include education, cognitive behavior therapy, leadership and professional coaching, and monitoring of the individual to ensure success. Unprofessional behaviors produce a variety of problems. Organizations have increasing obligations to all individuals involved: the In some cases, the more in-depth traditional assessment is needed. physician, staff and patients, too. LifeGuard created the clinically Clinically informed triage certainly does not disregard the traditional informed triage to address these behaviors. approach to professionalism assessments. In fact, in situations where patterns of disruptive behaviors are identified or concerns LifeGuard, a program of the non-profit Foundation of the Pennrelated to personality, psychiatric or substance abuse disorders sylvania Medical Society, helps physicians and their employers when are uncovered through the clinically informed triage process, the a situation arises that a physician's medical knowledge, clinical skills, traditional approach of assessment is employed to provide a more or health status are called into question. LifeGuard is a resource in-depth evaluation of the individual's behavior and the potential for the physician or other referring entities. LifeGuard's pathways, underlying triggers that lead to the behavioral issues. inclusive of recommended remediation, are uniquely tailored to the individual needs and specialty of each physician. Coupled with the ever-increasing pressures of medicine and empowerment of the clinical team rightfully demanding a respectful work environment, unprofessional behaviors are simply no longer tolerated. However, in many instances, this is not an easily tackled situation. Once the internal processes within the organization have been exhausted, what are the next steps in dealing with these behaviors? How do organizations turn for help with patterns of disruption? Traditional approaches may include an exhaustive review of the individual's past family and social history. Then a neuropsychological and psychiatric evaluation is performed which includes collection of a significant amount of data related to the specific behaviors and the effect of those behaviors in the workplace. These evaluations can be costly, time-consuming and in some situations, result in unwarranted negative labeling of the individual. Not every situation related to unprofessional behavior may require this approach. As medicine has had to respond to changes in a more efficient and rapid fashion, LifeGuard has answered a similar need with the LifeGuard has developed this innovative approach to answer the need for cost-effective and time-efficient professionalism assessments. LifeGuard's approach provides a proactive assessment in those situations when attempting to rapidly analyze a professionalism concern; returning, when appropriate, the individual to the work place with a newly acquired understanding of his or her behaviors, how those behaviors affect co-workers and patients, and tools to deal with triggers and stressors to eliminate unprofessional responses. The LifeGuard Mission LifeGuard strives to provide comprehensive clinical competency assessments tailored to the individual needs of health care professionals. LifeGuard also develops individualized recommendations for remediation (as applicable) based on deficiencies identified through the assessment process or as required by a state licensure board or a federal corporate integrity agreement. We aim to facilitate higher performing physicians, improved patient safety, and quality of medical care provided through carefully customized programs and individual case management. Please contact LifeGuard for more information about our professionalism assessment and "clinically informed triage" at 717-909-2590. See our website for other offerings including the Controlled Substance & Opioid Prescribing Educational Program now accepting 2017 registration at www.lifeguardprogram.com. 36 Philadelphia Medicine : Spring 2017
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