Children's Hospitals Today - Summer 2017 - 15

EMPLOYEE SAFETY / FEATURE

bout 20 percent of children in
the United States experience a
mental disorder in a given year,
and that rate is increasing, according
to the Centers for Disease Control and
Prevention (CDC). This increased prevalence of behavioral or conduct problems, attention-deficit/hyperactivity
disorder (ADHD), anxiety, depression
and autism spectrum disorders creates
increased demands on community resources and local hospitals.
Based on recent census data,
Nationwide Children's Hospital in
Columbus, Ohio, is expecting to care
for up to 180,000 children a year with
some level of mental illness within
the hospital's immediate service area.
Behavioral health care is a component
of the hospital's strategic plan, and as
a result, the organization is quickly
building the teams, facilities and culture to treat these patients and work
with their families.
But when caring for this patient population, staff members and health care
providers at Nationwide have found
a patient's behavior can be unpredictable, ranging from verbal outbursts
to combative situations that have resulted in staff members being spit on,
kicked or punched. The hospital has
daily occurrences where patients in
the Emergency Department (ED), the
inpatient psychiatric unit, youth crisis
stabilization unit or other inpatient or
outpatient areas inadvertently harm
employees during a time of mental or
emotional crisis.
Health care providers and hospital
employees know this behavior can occur when they're treating or interacting with patients, and employee harm is
unacceptable in any circumstance. But
according to the Occupational Health
and Safety Administration (OSHA),

this type of violence is typically not
reported-providers don't want to stigmatize the patient because of his or her
illness or mental state.
To reduce the number of incidents of
employees being harmed by combative patients, Nationwide developed a
multi-year initiative to prioritize employee safety. The hospital established
an employee safety team focused solely
on combative patient situations. Based
on incident reporting data, the team
has developed several interventions
that have reduced the frequency and
severity of employee harm.

Increased demand for
mental health services
In December 2014, Nationwide opened
an inpatient psychiatric unit with
16 beds designed to house acutely ill
children and adolescents with primary
psychiatric disorders including mood,
psychotic, disruptive behavior and
autism spectrum disorders. During the
first few months of the go-live phase,
the team in the unit focused on functioning differently from the typical
medical or surgical units, and engaged
and interacted with patients and their
families more frequently.
While the unit was providing critically important services to the community, there were some issues. For
example, the hospital had a 34 percent
increase in employee harm incidents
reported within the unit's first year.
These incidents included patients
spitting, biting, punching and hitting
employees or throwing objects at them.
Patients also ripped objects off of walls,
tore walls apart and accessed objects to
cause harm, including drywall screws.
With an increase in incident reporting, the employee safety team could
understand and prioritize risks related

CASE STUDY

Extra eyes and ears
keep employees safe
To help employees feel safe,
Children's Health in Dallas uses
LiveSafe, a smartphone app
that connects staff members to
the security team so they can
report security concerns within
the hospital. Employees can
send alerts as a text, photo or
video, and the security team
monitoring the hospital system
will dispatch the appropriate
response. GPS technology
helps security identify the
location of the user. A privacy
feature also allows users
to report emergencies and
communicate with security, but
without identifying themselves
or their location. LiveSafe also
offers parking lot security for
employees who are leaving
late at night. Through the app,
users can request the security
team monitor their walk to the
parking lot and make sure they
get to their vehicles safely. In
addition to keeping the campus
secure, the organization uses
LiveSafe to monitor the safety
and security of visiting home
staff members. When hospital
employees make off-site
trips, the security team can
track their movements and
make sure they arrive at their
destination safely, keeping the
line of communication open
throughout the trip.

CHILDREN'S HOSPITAL S TODAY Summer 2017

Table of Contents for the Digital Edition of Children's Hospitals Today - Summer 2017