Need clarity on behavioral harm alerts? We’ve got answers

On Nov. 15, 2021, Asante went live with a communication alert procedure for behavioral harm or violence. This includes FYI alert flags in Epic (for behavioral and violence issues) and a door sign to raise situational awareness for staff and help prevent occupational injury while working with patients at risk of violent and harmful behaviors.

Thank you for your feedback and survey responses! Here are some answers to your frequently asked questions:

Can this process be used in outpatient settings or is it only for inpatients?

This procedure applies to patients across the Asante system, and can be used for inpatient and outpatient encounters.

I still don’t understand how to place an FYI alert flag. How does this work?

The FYI alert flag can be placed on any chart using a standard process shown in the tip sheet found on myAsanteNET: Epic FYI Violence Issues Flag Tip Sheet —  #400-EPIC-NURS-0258.

In nursing areas that document in the flowsheet, a best practice advisory alert is triggered by documentation of qualifying behaviors. The BPA alert was designed to provide immediate resources and direction to improve safety measures. The BPA alert also links directly to the FYI flag activity.

Can I place an FYI alert flag if I did not witness the behavior?

Yes, there may be times where it is appropriate for a person who did not witness the behavior to place the FYI alert flag. Reasons may include:

• The witness is not authorized to place an FYI alert flag.
• The witness is outside our facility and reported the behavior.
• The witness was unable to add the FYI alert flag at the time of the event and the safety risk remains.

What do I document on the FYI alert flag note?

The note is meant to help us ensure safety for the patient and staff by sharing objective information.

Content of the FYI alert flag includes:

• The alert type, author, date and time.
• The patient’s name.
• An objective description of event that meets criteria for flagging.
• Triggers and safety responses and precautions.

Use the easy pre-formatted SmartPhrase “DotPhrase” or SmartText with built-in template using the key word “violent.”

 I didn’t know we have door signs in patient care areas. How do we get those?

Signs should be available where you store other signs in patient care departments (e.g. COVID signs). You can also download a sign by clicking this link or the image above. Larger quantities may be ordered through Infor (item: HR 100600).

Do these communication tools really help?

The more we use them, the more helpful they are. The evidence shows that increased situational awareness protects staff and patients during potentially unsafe encounters.

An Asante staff survey showed enthusiasm for communication tools, such as the FYI alert flag and door signs, to improve safety.

From Dec. 1, 2021, to March 31, 2022, 138 FYI alert flags for violence and behavioral issues have been placed.

For questions and concerns, email Wo********************************@as****.org.

Resources

• Communication Alerts for Patient Behavioral Harm or Violence Procedure #400-PCS-NURS-0958 can be found on myAsanteNET.
• Epic FYI Violence Issues Flag Tip Sheet #400-EPIC-NURS-0258 can be found on myAsanteNET.
• Review the Communication Alerts for Patient Behavioral Harm or Violence at Asante ALEC module.
• Additional door signs can be ordered in Infor (item: HR 100600). Door signs will soon be printable on the Workplace Violence Prevention website on myAsanteNET.

Trina Thomas serves on Asante’s Workplace Violence Prevention Committee.