Skip to main content
Top
Published in: Journal of Medical Systems 1/2023

01-12-2023 | Original Paper

National Development and Implementation of a Democratized Disruptive Behavior Reporting System in Health Care

Authors: Scott Hutton, Kelly Vance, Shawn M. Loftus, Greg Roth, Lynn M. Van Male

Published in: Journal of Medical Systems | Issue 1/2023

Login to get access

Abstract

Introduction

Workplace disruptive behavior/ violence (WDBV) is underreported in health care. This study evaluated a 7-year implementation of the Disruptive Behavior Reporting System (DBRS), the most robust consolidated WDBV reporting system developed in the United States within the Veterans Health Administration (VHA).

Methods

After implementation of the system, implementation success was measured in real time by number of reports, types of staff entering reports, time to review the reports and time between when the incident occurred and report entry.

Results

Over the seven years since implementation, there has been a significant increase in reporting within DBRS with more than 50,000 reports in fiscal year (FY) 2021 up from 0 to 2014. Types of staff reporting increased to 67 from 54. The median number of days to review events in FY19 Q2 was 4.79 days and the report latency has almost completely disappeared.

Discussion

DBRS was designed to democratize reporting so staff can report WDBV anytime and anywhere playing a large role in the successful implementation. The increase in total number of reported events is an indication of the success of the system as it captures data historically lost due to underreporting.

Conclusion

DBRS development and implementation showcases how information systems can empower front-line personnel to voice behavioral safety concerns.
Literature
2.
go back to reference J. E. Arnetz, D. Aranyos, J. Ager and M. J. Upfal, (2011) “Development and application of a population-based system for workplace violence surveillance in hospitals,“ American Journal of Industrial Medicine, pp. 925–934,. J. E. Arnetz, D. Aranyos, J. Ager and M. J. Upfal, (2011) “Development and application of a population-based system for workplace violence surveillance in hospitals,“ American Journal of Industrial Medicine, pp. 925–934,.
3.
go back to reference Emergency Nurses Association (2011), “Emergency Department Violence Surveillance Study November 2011,“ Emergency Nurses Association, Des Plaines, IL,. Emergency Nurses Association (2011), “Emergency Department Violence Surveillance Study November 2011,“ Emergency Nurses Association, Des Plaines, IL,.
4.
go back to reference E. Harrell (2016), “Workplace violence, 1993–2009. [electronic resource]: National crime victimization survey and census of fatal occupational injuries,“ Washington, DC : U.S. Dept. of Justice, Office of Justice Programs, Bureau of Justice Statistics. E. Harrell (2016), “Workplace violence, 1993–2009. [electronic resource]: National crime victimization survey and census of fatal occupational injuries,“ Washington, DC : U.S. Dept. of Justice, Office of Justice Programs, Bureau of Justice Statistics.
5.
go back to reference S. Hutton (2006), “Workplace incivility: State of the Science,“ The Journal of Nursing Administration, pp. 22–27; Discussion 27–28,. S. Hutton (2006), “Workplace incivility: State of the Science,“ The Journal of Nursing Administration, pp. 22–27; Discussion 27–28,.
6.
go back to reference J. A. Kinney and D. L. Johnson (1993), Breaking point: The workplace epidemic and what to do about it., Chicago: National Safe Workplace Institute,. J. A. Kinney and D. L. Johnson (1993), Breaking point: The workplace epidemic and what to do about it., Chicago: National Safe Workplace Institute,.
7.
go back to reference U.S. Department of Justice (Accessed 5 Setember 2016), Office of Justice Programs, Bureau of Justice Statistics, “1993–2009 National Crime Victimization Survey and the Census of Fatal Occupational Injuries.,“ March 2011. [Online]. Available: www.bjs.gov/content/pub/pdf/wv09.pdf. U.S. Department of Justice (Accessed 5 Setember 2016), Office of Justice Programs, Bureau of Justice Statistics, “1993–2009 National Crime Victimization Survey and the Census of Fatal Occupational Injuries.,“ March 2011. [Online]. Available: www.​bjs.​gov/​content/​pub/​pdf/​wv09.​pdf.
9.
go back to reference R. Wyatt, K. Anderson-Drevs and L. M. Van Male (2016), “Workplace Violence in Health Care A Critical Issue With a Promising Solution,“ JAMA, pp. 1037–1038,. R. Wyatt, K. Anderson-Drevs and L. M. Van Male (2016), “Workplace Violence in Health Care A Critical Issue With a Promising Solution,“ JAMA, pp. 1037–1038,.
10.
go back to reference National Quality Forum Action Team (2022), “NQP Action Team to Prevent Healthcare Workplace Violence,“. [Online]. Available: file:///C:/Users/VHACIN~1/AppData/Local/Temp/1/MicrosoftEdgeDownloads/8f3eb2f2-c9b3-4e18-ac0c-d5dae09718a2/nqp_action_team_to_prevent_healthcare_workplace_violence_issue_brief.pdf. National Quality Forum Action Team (2022), “NQP Action Team to Prevent Healthcare Workplace Violence,“. [Online]. Available: file:///C:/Users/VHACIN~1/AppData/Local/Temp/1/MicrosoftEdgeDownloads/8f3eb2f2-c9b3-4e18-ac0c-d5dae09718a2/nqp_action_team_to_prevent_healthcare_workplace_violence_issue_brief.pdf.
11.
go back to reference L. Van Male, K. Vance, S. Hutton and B. Truman (2018), “Comprehensive Workplace Violence Prevention Program: Model and Process Success in a National Healthcare System,“ in Fourth International Conference on Violence in the Health Sector Towards safety, security and wellbeing for all, Toronto,. L. Van Male, K. Vance, S. Hutton and B. Truman (2018), “Comprehensive Workplace Violence Prevention Program: Model and Process Success in a National Healthcare System,“ in Fourth International Conference on Violence in the Health Sector Towards safety, security and wellbeing for all, Toronto,.
12.
go back to reference U.S Department of Labor Occupational Safety and Health Administration (2015), “Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers,“ Department of Labor, Washington DC,. U.S Department of Labor Occupational Safety and Health Administration (2015), “Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers,“ Department of Labor, Washington DC,.
14.
go back to reference J. E. Arnetz, L. Hamblin, J. Ager, M. Luborsky, M. J. Upfal, J. Russell and L. Essenmacher (2015), “Underreporting of Workplace Violence: Comparison of Self-Report and Actual Documentation of Hopsital Incidents,“ Workplace Health Safety, pp. 200–210. J. E. Arnetz, L. Hamblin, J. Ager, M. Luborsky, M. J. Upfal, J. Russell and L. Essenmacher (2015), “Underreporting of Workplace Violence: Comparison of Self-Report and Actual Documentation of Hopsital Incidents,“ Workplace Health Safety, pp. 200–210.
15.
go back to reference T. Ferns and E. Meerabeau (2009), “Reporting behaviours of nursing students who have experienced verbal abuse,“ Journal of Advance Nursing, pp. 2678–2688,. T. Ferns and E. Meerabeau (2009), “Reporting behaviours of nursing students who have experienced verbal abuse,“ Journal of Advance Nursing, pp. 2678–2688,.
16.
go back to reference D. M. Gates (2004), “The epidemic of violence against healthcare workers.,“ Occupational and Enviromental Medcine, pp. 649–650,. D. M. Gates (2004), “The epidemic of violence against healthcare workers.,“ Occupational and Enviromental Medcine, pp. 649–650,.
17.
go back to reference A. Kvas and J. Seljak (2014), “Unreported workplace violence in nursing,“ International Nursing Review, pp. 344–351,. A. Kvas and J. Seljak (2014), “Unreported workplace violence in nursing,“ International Nursing Review, pp. 344–351,.
18.
go back to reference M. L. Lanza and D. Campbell (1991), “Patient assault: A comparison study of reporting methods,“ Journal of Nursing Quality Assurance, pp. 60–68,. M. L. Lanza and D. Campbell (1991), “Patient assault: A comparison study of reporting methods,“ Journal of Nursing Quality Assurance, pp. 60–68,.
19.
go back to reference k. Sato, T. Wakabayashi, H. Kiyoshi-Teo and H. Fukahori (2012), “Factors associated with nurses’ reporting of patients’ aggressive behavior: A cross-sectional survey,“ International Journal of Nursing Studies, pp. 1368–1375,. k. Sato, T. Wakabayashi, H. Kiyoshi-Teo and H. Fukahori (2012), “Factors associated with nurses’ reporting of patients’ aggressive behavior: A cross-sectional survey,“ International Journal of Nursing Studies, pp. 1368–1375,.
20.
go back to reference C. Kivlahan, W. Sangster, K. Nelson, J. Buddenbaum and K. Lobenstein (2002), “Developing a Comprehensive Electronic Adverse Event Reporting System in an Academic Health Center,“ Journal on Quality Improvement, pp. 583–594,. C. Kivlahan, W. Sangster, K. Nelson, J. Buddenbaum and K. Lobenstein (2002), “Developing a Comprehensive Electronic Adverse Event Reporting System in an Academic Health Center,“ Journal on Quality Improvement, pp. 583–594,.
21.
go back to reference L. A. Pompeii, A. Schoenfisch, H. J. Lipscomb, J. M. Dement, C. D. Smith and S. H. Conway (2016), “Hospital Workers Bypass Traditional Occupational Injury Reporting Systems When Reporting Patient and Visitor Perpetrated (Type II) Violence,“ AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, pp. 853–865,. L. A. Pompeii, A. Schoenfisch, H. J. Lipscomb, J. M. Dement, C. D. Smith and S. H. Conway (2016), “Hospital Workers Bypass Traditional Occupational Injury Reporting Systems When Reporting Patient and Visitor Perpetrated (Type II) Violence,“ AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, pp. 853–865,.
22.
go back to reference M. J. Findorff, P. M. McGovern, M. M. Wall and S. G. Gerberich (2005), “Reporting violence to a health care employer: A cross-sectional study,“ AAOHN Journal, p. 399–406,. M. J. Findorff, P. M. McGovern, M. M. Wall and S. G. Gerberich (2005), “Reporting violence to a health care employer: A cross-sectional study,“ AAOHN Journal, p. 399–406,.
23.
go back to reference H. D. Byon, M. Lee, M. Choi, K. Sagherian, M. Crandall and J. Lipscomb (2020), “Prevalence of type II workplace violence among home healthcare workers: A meta-analysis,“ American journal of Industrial Medicine, pp. 442–455,. H. D. Byon, M. Lee, M. Choi, K. Sagherian, M. Crandall and J. Lipscomb (2020), “Prevalence of type II workplace violence among home healthcare workers: A meta-analysis,“ American journal of Industrial Medicine, pp. 442–455,.
24.
go back to reference T. F. Small, G. L. Gillespie, E. B. Kean and S. Hutton (2022), “Workplace Violence Interventions Used by Home Healthcare Workers,“ Home Healthcare Now, vol. 38, no. 4, pp. 193–201,.CrossRef T. F. Small, G. L. Gillespie, E. B. Kean and S. Hutton (2022), “Workplace Violence Interventions Used by Home Healthcare Workers,“ Home Healthcare Now, vol. 38, no. 4, pp. 193–201,.CrossRef
25.
go back to reference L. Bensley, N. Nelson, J. Kaufman, B. Silverstein, J. Kalat and J. W. Shields (1997), “Injuries due to assaults on psychiatric hospital employees in Washington state,“ American Journal of Industrial Medicine, pp. 92–99,. L. Bensley, N. Nelson, J. Kaufman, B. Silverstein, J. Kalat and J. W. Shields (1997), “Injuries due to assaults on psychiatric hospital employees in Washington state,“ American Journal of Industrial Medicine, pp. 92–99,.
26.
go back to reference J. E. Arnetz, D. Aranyos, J. Ager and M. J. Upfal (2011), “Worker-on-worker violence among hospital employees,“ International Journal of Occupational Medicine and Environmental Health, p. 328–335,. J. E. Arnetz, D. Aranyos, J. Ager and M. J. Upfal (2011), “Worker-on-worker violence among hospital employees,“ International Journal of Occupational Medicine and Environmental Health, p. 328–335,.
27.
go back to reference J. M. Chamberlain, K. N. Shaw, K. A. Lillis, P. V. Mahajan, R. M. Ruddy, R. Lichenstein, C. S. Olsen and J. M. Dean (2013), “Creating an Infrastructure for Safety Event Reporting and Analysis in a Multicenter Pediatric Emergency Department Network,“ Pediatric Emergency Care, pp. 125–130,. J. M. Chamberlain, K. N. Shaw, K. A. Lillis, P. V. Mahajan, R. M. Ruddy, R. Lichenstein, C. S. Olsen and J. M. Dean (2013), “Creating an Infrastructure for Safety Event Reporting and Analysis in a Multicenter Pediatric Emergency Department Network,“ Pediatric Emergency Care, pp. 125–130,.
28.
go back to reference D. Peddie, S. S. Small, K. Badke, M. E. Wickham, C. Bailey, A. Churscicki, C. Ackerley, E. Balka and C. M. Hohl (2016), “Designing an Adverse Drug Event Reporting System to Prevent Unintentional Reexposures to Harmful Drugs: Study Protocol for a Multiple Methods Design,“. D. Peddie, S. S. Small, K. Badke, M. E. Wickham, C. Bailey, A. Churscicki, C. Ackerley, E. Balka and C. M. Hohl (2016), “Designing an Adverse Drug Event Reporting System to Prevent Unintentional Reexposures to Harmful Drugs: Study Protocol for a Multiple Methods Design,“.
29.
go back to reference K. Vance, L. Van Male, D. Mohr, J. Lipkowitz-Eaton and K. McPhaul (2014), “Using workplace behavioral incident data to assign employee training: Models for formulating risk.,“ in Proceedings of the Fourth International Conference on Violence in th Health Sector Towards safety, security and wellbeing for all, Miami,. K. Vance, L. Van Male, D. Mohr, J. Lipkowitz-Eaton and K. McPhaul (2014), “Using workplace behavioral incident data to assign employee training: Models for formulating risk.,“ in Proceedings of the Fourth International Conference on Violence in th Health Sector Towards safety, security and wellbeing for all, Miami,.
31.
go back to reference E. B. Elbogen, S. C. Johnson, R. Wagner, V. M. Newton, C. Tinko, J. J. Vasterling and J. Beckham (2012), “Protective Factors and Risk Modification of Violence in Iraq and Afghanistan War Veterans,“ Journal of Clinical Psychiatry, vol. 73, no. 6, pp. 767–773,.CrossRef E. B. Elbogen, S. C. Johnson, R. Wagner, V. M. Newton, C. Tinko, J. J. Vasterling and J. Beckham (2012), “Protective Factors and Risk Modification of Violence in Iraq and Afghanistan War Veterans,“ Journal of Clinical Psychiatry, vol. 73, no. 6, pp. 767–773,.CrossRef
32.
go back to reference S. D. Hart, K. S. Douglas and L. S. Guy (2016), “he structured professional judgement approach to violence risk assessment: Origins, nature, and advances.,“ The Wiley handbook on the theories, assessment and treatment of sexual offending,, vol. 2, pp. 643–666. S. D. Hart, K. S. Douglas and L. S. Guy (2016), “he structured professional judgement approach to violence risk assessment: Origins, nature, and advances.,“ The Wiley handbook on the theories, assessment and treatment of sexual offending,, vol. 2, pp. 643–666.
33.
go back to reference C. D. Webster, Q. Haque and S. Hucker (2013), Violence Risk - Assessment and Management: Advances Through Structured Professional Judgement and Sequential Redirections Second Edition, Hamilton: John Wiley & Sons,.CrossRef C. D. Webster, Q. Haque and S. Hucker (2013), Violence Risk - Assessment and Management: Advances Through Structured Professional Judgement and Sequential Redirections Second Edition, Hamilton: John Wiley & Sons,.CrossRef
Metadata
Title
National Development and Implementation of a Democratized Disruptive Behavior Reporting System in Health Care
Authors
Scott Hutton
Kelly Vance
Shawn M. Loftus
Greg Roth
Lynn M. Van Male
Publication date
01-12-2023
Publisher
Springer US
Published in
Journal of Medical Systems / Issue 1/2023
Print ISSN: 0148-5598
Electronic ISSN: 1573-689X
DOI
https://doi.org/10.1007/s10916-023-01999-0

Other articles of this Issue 1/2023

Journal of Medical Systems 1/2023 Go to the issue