Due to the rise in acts of violence against healthcare workers across the nation, healthcare facilities are implementing unique and innovative approaches to mitigate the risk to their staff while providing the best care for their patients. The University of Kansas Health System is leading the way with novel pathways to support staff who experience acts of violence in the workplace. In partnership with our health system's Workplace Violence Prevention Committee, a small team gathered to create a pathway to recovery for these employees. This blog describes implementation of a new program to support staff members who experience violence.
Leveraging the team's time and talent, our health system implemented a multidisciplinary approach without incurring additional expense. We combined our spiritual care team, psychiatric and behavioral health specialty team members and forensic nurses to develop a support response for employees who have experienced workplace violence. This multidisciplinary team applied their unique education and skill sets to develop the program, which is called E-SAVE (Employee Support After a Violent Event).
Historically, our forensic nurses have focused on caring for patients who are victims of crime. The forensic nursing team is also well equipped and educated to care for, support and educate our employees who have experienced acts of violence in the workplace, including assaults. This team is trained in a trauma-informed approach, using clinical assessment skills to evaluate a person's short- and long-term mental health needs. This knowledge helps them select the support resources that should be offered acutely as well as in the long-term for specific follow-up needs. The forensic nurse who provides immediate support serves in the role of employee advocate on the E-SAVE team.
The forensic nurse helps the employee process their experience, informed by understanding the effects of trauma known as the neurobiology of trauma. Providing resources acutely after a traumatic event changes the way the victim's brain processes the situation. The forensic nurse's knowledge of the effects of trauma helps them provide needed resources at the appropriate time. Also, the forensic nurse can help with reporting procedures, including the internal reporting process and occupational health processes. The forensic nurse is highly qualified to assist with resources and, most importantly, provides the employee with the appropriate support in the moment and continuing, in order to support healing.
The forensic nurse continues to provide support after the event by creating an ongoing plan for follow-up and providing information about internal resources such as our Helping Our People Endure (HOPE) team. The HOPE team provides second victim peer support and information about our Employee Assistance Program. Employees are encouraged to report an event to the police. If charges are filed and an employee needs to be in court, the forensic nurse attends the proceedings along with the employee to provide support. Before the court appearance, the forensic nurse reviews the process with the employee, so they are prepared.
While the forensic nurse is supporting the worker who experienced violence, several other team members assess the needs of the unit or department, while caring for the worker's patients, and addressing staffing changes if needed.
- Our chaplain visits patients at the bedside to help address their needs and rounds on the unit to ensure other concerned staff members receive resources, as needed. Often, the chaplain has already developed a certain level of rapport with patients and will sit with them to listen and understand. Because the chaplain has developed these relationships, and they are a calming presence for patients, they play a significant role in decreasing repeat behavioral response activations, resulting in movement toward prevention rather than reaction.
- Our psychiatric behavioral health specialists also have a significant role in the response to workplace violence events. These team members play an essential role in the treatment of patients with complex behavioral health needs. They assist with patient assessment and care, collaborate with the nurse manager to develop a behavioral management plan, and provide ongoing support and rounding for the unit. These specialists also provide backup services for the employee advocate role. Skilled at evaluating mental health needs, they are essential in providing acute resources for both patients and employees.
During the pilot, from October 2023 to June 2024, the E-SAVE team supported 52 employees during 32 activations. We continue to expand to different locations. From July 2024 through January 2025, we supported an additional 50 employees during 32 activations. The goal is full coverage, 24/7, throughout the health system by FY2026.
Through evaluation, we learned employees at our organization feel supported and are processing traumatic and stressful events in a meaningful way. One employee said, "I have never worked anywhere where I feel so supported." She now wants to play a larger role for patients with behavioral health needs and is seeking more education to provide specific care for this population. Instead of being negatively affected by her traumatic event, with support and resources, she is not only thriving but helping provide better care for patients at our organization. Another employee shared, "I am just grateful I work in a place where I feel comfortable opening up to the charge nurses when they ask if I am doing OK. I think I will be OK; it will just take some time." As we continue to improve the process and identify strategies for sustainability, the team is finding fulfillment in providing care for a very important aspect of our health system, the people who work here.
I gratefully acknowledge the contributions of the following individuals from the University of Kansas Health System; their efforts have led to the success of our program:
Heidi Boehm, MSN, RN-BC, CPPS, is a program manager for enterprise initiatives for complex behavioral health quality and safety. She serves as project manager for E-SAVE, manages the data and supports promotion.
Liz Carlton, MSN, RN, CCRN, CPHQ, CPPS, is senior vice president for quality, safety, and operational integration and executive sponsor of the Workplace Violence Prevention Program.
Kristyna Tan, LCSW, is a specialist in the Department of Nurse Psychiatric Behavioral Health and serves on the E-SAVE team.
Daniel Freeman is a chaplain and a member of the E-SAVE team.
Stephanie Burger is a director of nursing and an operational owner of the E-SAVE program.
Becky Ramel, BSN, NEA, is a nurse manager and an operational owner of the E-SAVE program.
How will you become a changemaker to support employees who experience acts of violence at work?
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