The Royal College of Emergency Medicine (RCEM) has published new guidance on the practical actions that Emergency Departments (EDs) can and should take to make their workplaces safer for staff. The move follows the results of a recent survey that revealed the prevalence of violence and aggressions towards the ED and staff working there; more than three quarters of ED clinicians (73%) said they witnessed or experienced violence and aggression from members of the public or patients at least once a week.
The RCEM’s Toolkit for the Prevention and Management of Violence in the Emergency Department is freely available on the RCEM website and includes information on the drivers of violence and aggression in EDs, suggested training for staff and contains a host of recommendations on how to address the problem that should help organisations to take practical steps.
The toolkit has been created by RCEM’s Quality in Emergency Care Committee and all of its recommendations are based on measures that have already been proven to make a positive difference in UK hospitals, ensuring staff are safer and better supported at work.
Recommendations include
• Training for staff in ‘customer care”’ de-escalation, conflict resolution and trauma informed care
• Triage systems that identify patients that may struggle with an ED environment, so they can be managed pro-actively
• Specific care for patients at risk of agitation due to mental health crisis, intoxication, learning disability, dementia and delirium
• Creating safe, low stimulus spaces
• Closer working with security teams, including rapid response teams
• Use of body worn video camera
• Easy ways of reporting incidents
• Multidisciplinary review of incidents in order to improve prevention, care for staff, develop care plans for patients and liaise with the police.
Dr Ian Higginson, RCEM President, says: “Colleagues across the country, and indeed across the health service, face unacceptable levels of violence and aggression from patients and members of the public every day. It cannot be accepted as ‘part of the job’.
“This toolkit, available online for anyone to refer to, can be used to bring about change at the hospital level to help bring down levels of violence, monitor the issue and support those who have been impacted.
“We strongly encourage staff to read the guidance, and use it as way of informing their own approaches to this problem, and of encouraging their management teams, including CEOs, to engage with the problem with practical actions.
“However, we know that without wider support, there are a limited range of solutions available at a local level, so RCEM continues to lobby on this issue at the highest levels of government and NHS leadership to ensure structural changes are brought in to address it.”
