Program results indicate a marked reduction in emergency codes and staff injuries. PDSA and QAPI were critical to success. The initiative has caused a positive shift in culture and safety within the hospital. There is a need for additional training on de-escalation techniques and interdepartmental communication related to psychiatric emergencies. A team was established to prevent psychiatric code emergencies from occurring and to reduce staff injuries. The CPRT team comprised of 25 hospital employees educated in de-escalation and crisis response tactics was created as part of a Plan-Do-Study-Act (PDSA) performance improvement plan. There were 1360 psychiatric emergency codes initiated in 2020 compared to the 848 codes initiated in 2021. There were only 596 in 2022. Staff injuries categorized as ‘combative’ decreased from 125 in 2020 to 74 injuries in 2021. There were 84 injuries in 2022. As a result of the new program, psychiatric emergency codes and staff injuries diminished.
Problem: This study was conducted to evaluate the effectiveness of the CPRT team within a state-run inpatient psychiatric hospital is needed. Despite numerous discussions and initiatives aimed at reducing aggression and violence, psychiatric codes and staff injuries worsened year after year.
Measurement:The PDSA performance improvement framework was utilized. Monthly Quality Assurance Performance Improvement (QAPI) Committee meetings reporting were utilized to track progress and ensure accountability of the initiative. MS PowerBI software was utilized to illustrate results.
Analysis: A paired t-test was conducted using SPSS software to evaluate the impact of a Crisis Prevention and Response Team (CPRT) on Psychiatric Emergency Codes and Staff Injuries at Eastern State Hospital, from 2020 until 2022.
Implementation: Initially, 10 members were hired for the crisis response team. Obstacles included methods of staffing and oversight of the team within the hospital. Although codes and injuries decreased, we recognized a need to hire additional staff and a management team. Benefits and applications include best practices to improve patient outcomes.
