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Proactive Psychiatry Intervention Using a Nurse-Led Behavioral Response Model for Hospitalized Patients With Behavioral Disturbances

Afriyie-Boateng, Mavis; Loftus, Carla; Wiesenfeld, Lesley; Hunter, Meghan; Lawson, Andrea

The Journal for Healthcare Quality (JHQ): September/October 2019 - Volume 41 - Issue 5 - p 267–273
doi: 10.1097/JHQ.0000000000000208
Original Article

Background: The health care sector has one of the highest rates of workplace violence, putting staff at risk and impeding care. To deliver quality health care, staff need targeted resources. This article describes a program to improve staff safety and reduce barriers to care for patients with behavioral disturbances.

Program Description: A nurse-led behavioral response team was created to identify high-risk patients and offer prompt targeted interventions. The Behavioral Optimization and Outcomes Support Team (BOOST) was implemented in November 2012, in conjunction with a proactive model of care, enabling psychiatric intervention. Advanced practice nurses in psychiatry respond to requests from staff on medical/surgical units to assist with management of behavioral disturbances.

Methods: Consultation and intervention data were reviewed, and staff satisfaction surveys were completed to evaluate the program.

Results: The program has contributed to staff feeling more supported and safer at work. There has also been a reduction in staff's experience of perceived burden in the care of patients with behavioral disturbances although they are caring for more of these patients.

Conclusions: Although violence risk in health care continues to be a significant issue, programs to intervene early can be effective in supporting staff to minimize these risks.

For more information on this article, contact Mavis Afriyie-Boateng at

© 2019 National Association for Healthcare Quality
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