Workplace violence in healthcare is an ongoing problem. Violence and the threat of violence affect all types of providers. In recent years, healthcare leaders have sought and implemented solutions to improve employee safety in healthcare.
Behavioral Emergency Response Teams (BERT) are emerging as a practical addition to healthcare workplace best practices. BERT teams are rapid response teams that mitigate violence in situations where behavioral health could be a factor.
Behavioral Health Crises are Increasing
According to the 2024 State of Mental Health America report, there is currently a critical need for effective behavioral health interventions in clinical settings.
- Nearly 60 million adults (23.08%) experienced a form of mental illness in the past year.
- Nearly 13 million adults (5.04%) reported serious thoughts of suicide.
- More than 45 million adults (17.82%) and 2.3 million youth (8.95%) are experiencing a substance use disorder.
- More than nine in ten (91%) emergency physician respondents report being threatened or attacked in the past year.
- Nearly three-quarters (71%) of respondents believe that violence in the emergency department is worse than last year.
Behavioral health incidents are occurring with greater frequency, and these incidents can lead to violence in healthcare settings. Rapid response to behavioral health emergencies is, therefore, a critical need.
How BERTs Intervene
Behavioral Emergency Response Teams (BERT) are a heterogeneous mixture of interdisciplinary, psychiatrically trained team members who deploy to behavioral emergencies across hospitals and other clinical settings. These teams deploy like medical rapid response teams.
Emergency Departments are frequently the site of behavioral health emergencies. According to a University of Kansas study of behavioral health emergencies in Emergency Departments, behavioral emergencies comprised approximately 10 percent of the local county hospital Emergency Department (ED) volume. This problem is widespread: throughout the US, behavioral crises account for approximately one in eight ED visits. The trauma-informed de-escalation interventions BERTs deploy aim to move patients from a hyper-aroused state back into the window of tolerance so that providers can effectively engage in patient care.
BERTs prioritize the de-escalation of behavioral health emergencies. Like medical rapid response teams, BERTs emphasize identifying early warning signs. Teams respond to these early warning signs of behavioral distress as rapidly as possible. When patient-clinician relationships become fraught, interdisciplinary BERT members are all trained to preserve patient-centeredness through de-escalation and problem-solving. As BERT members perform this complex work, clinicians can perform proactive clinical investigation and treatment. By remaining attuned to early warning signs, BERT members can de-escalate situations, ensure patients receive the necessary medical treatment, and improve safety in healthcare.
Ideally, a BERT is activated before a patient demonstrates an outward act of internal distress. Often, BERTs include security staff who operate under the direction of clinicians and can assist in a primary security response if needed. Clear communication about the responsibilities of each BERT member and an effective means of initiating a BERT response empowers all team members to participate in de-escalation and response efforts.
BERT Impact on Safety in Healthcare
The presence of BERTs in healthcare facilities helps reduce rates of workplace violence in healthcare. BERT members’ training empowers them to de-escalate behavioral health emergencies. This mitigates the violence that occurs when de-escalation teams and protocols are unavailable.
The impact of BERT intervention is critical: healthcare workers are 5x more likely to experience workplace violence than workers overall, and that number is estimated to be exceptionally underreported. To improve safety in healthcare, Henry Ford Health recommends that healthcare facilities promote workplace safety and decrease adverse events by designating response personnel to perform critical functions:
- Implement activation criteria.
- Employ de-escalation techniques.
- Debrief.
- Determine evaluation strategies.
BERTs that perform these functions improve healthcare safety for both patients and healthcare workers. Through de-escalation, BERTs can decrease workplace violence, decrease security intervention, decrease restraint use, increase staff perception of workplace safety, and improve patient care for behavioral health patients on medical units.
Proactive Support for Healthcare Workers
Penn Medicine Chester County Hospital implemented its BERT as a proactive approach to patient and healthcare worker safety. According to Kyle Finucane, MSW, director of behavioral health at the hospital, “The BERT was initiated with the goals of decreasing incidents and increasing the frontline staff’s toolkit and confidence in working with patients with behavioral needs, with the ultimate goal of decreasing episodes of workplace violence.” Nine months after implementation, the hospital experienced a 70% decrease in patient agitation after BERT intervention.
A 2024 study revealed that BERTs can improve employee well-being and workplace morale in healthcare settings. The study revealed the following findings:
- BERT implementation reduces workplace violence.
- BERT implementation reduces costs related to staff injuries.
- Healthcare workers feel more supported in settings that implement BERTs.
- Healthcare workers perceive that BERT implementation helps improve communication, teamwork, confidence in caring for patients in a behavioral health crisis, staff comfort level with de-escalation, relations with police and the hospital’s security team, staff attitude toward behavioral health patients, and feeling safe in the workplace.
Hospitals and clinics improve workers’ sense of safety and job satisfaction by implementing BERTs. The downstream effects of BERT implementation include improved patient care, increased staff retention, and fewer workplace injuries and violent incidents.
CENTEGIX Safety Solutions Enhance BERT Response
CrisisAlert™
CENTEGIX safety solutions help facilitate BERT interventions more efficiently. CENTEGIX CrisisAlert is a wearable duress button that empowers healthcare workers to initiate alerts discreetly. By pushing their wearable button, BERT members can initiate an accelerated response without further escalating a behavioral health emergency.
A hospital or clinic’s greatest asset is its staff. Tools that empower staff to maximize the effectiveness of their response, mitigate workplace violence in healthcare, and provide workers with a sense of safety on the job. CrisisAlert:
- Improves collaboration among responders; instant deployment of BERTs means more time for trained experts to de-escalate emergencies.
- Empowers staff with information; the central dashboard provides administrators and staff leaders with precise and up-to-the-minute information.
- Provides campuswide coverage; staff can initiate an alert from anywhere on campus.
- Empowers BERTs to escalate the alert level if necessary.
Safety Blueprint™
CrisisAlert utilizes CENTEGIX Safety Blueprint, a dynamic digital map that enables staff leaders to see precise location information. By using critical incident mapping technology, BERTs can accelerate response times by pinpointing the locations of people and ongoing incidents.
Safety Blueprint maps also include the hospital or clinic’s infrastructure and safety assets, including:
- Restraints
- Automatic defibrillator devices (AEDs)
- Fire alarms and extinguishers
- Evacuation routes
- Stairwell locations
- Emergency rally points (emergency gathering places)
Safety assets are critical to a BERT’s rapid response, and Safety Blueprint makes this visual data available in real-time. Through CrisisAlert, Safety Blueprint enhances and maximizes the powerful work that BERTs perform in the healthcare workplace.
CENTEGIX technology facilitates safety in healthcare settings. By bolstering a facility’s BERT efforts, CENTEGIX helps healthcare facilities create a culture of safety that improves employee satisfaction and retention and allows healthcare workers to focus on patient care.
Request a demo today to learn more about how CENTEGIX safety solutions enhance BERT efforts and improve safety in healthcare.
