Abstract
During early 2024 we averaged 8.8 type-two workplace violence incidents increasing to 19 incidents in September. After workplace-related high-profile staff injuries occurred and our staff verbalizing increased concerns during patient interactions, staff were reporting practice changes to avoid patients they felt were agitated. A deficiency in staff on identification, mitigation and de-escalation of these patient behaviors (Bruccoli, 2023) was noted. The team evaluated best practices locally, regionally and within current literature, concluding that the implementation of a Behavioral Emergency Response Team (BERT) would be ideally suited to reduce workplace violence (Parker, et al. 2020).
Literature review identified the consistent effectiveness that BERT Teams demonstrated to decrease behavioral emergencies, workplace violence and staff injuries. We shifted our focus to underlying medical causality for behavioral emergencies rather than intentional conduct. We reviewed current practices and available resources to attain our goals of decreased workplace violence. This showed that specially trained staff were critical to BERT success and we hired additional mental health technicians in response.
A comprehensive education plan was developed that included Crisis Prevention (CPI) training, de-escalation and mitigation training, simulation-based courses and mock BERT drills prior to implementation.
Since deploying Code BERT in October of 2024 there has been a decrease in Type two Workplace Violence incidents towards staff. Prior to BERT initiation the eight-month average for incidents for 2024 was 8.8 with a rate of 12.46/1000 patient days. Post-initiation, our four-month average dropped to 4.25 with a rate of 3.99/1000 patient days. Our staff report increased confidence when interacting with patients experiencing behavioral emergencies, feeling that their voice was heard and reassured that they can call a specially trained team when assistance is needed.
In assessing post-deployment resource utilization, there has been a decrease in all workplace violence incidents, specifically Code BERT activations coupled with a decrease in code purples from 18 to three indicated a tailored approach to targeted medical management of behavioral emergencies. Focused treatment of medically induced behavioral changes provides patients earlier intervention, decreases agitation and potentially decreases length of stay when medically comorbid issues are treated earlier.
Notes
Reference list included in attached slide deck.
Sigma Membership
Non-member
Lead Author Affiliation
Houston Methodist West Hospital, Houston, Texas, USA
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Implementation Science, Acute Care, Teaching and Learning Strategies, Workplace Violence, Rapid Response Team, Behavioral Emergency Response Team
Recommended Citation
Ozdenvar, Marcia L. and Olsson, Mimi, "Behavioral Emergencies: Workplace Violence? We Have a Plan (BERT Team Implementation)" (2026). International Nursing Research Congress (INRC). 54.
https://www.sigmarepository.org/inrc/2026/presentations_2026/54
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-07-25
Behavioral Emergencies: Workplace Violence? We Have a Plan (BERT Team Implementation)
Toronto, Ontario, Canada
During early 2024 we averaged 8.8 type-two workplace violence incidents increasing to 19 incidents in September. After workplace-related high-profile staff injuries occurred and our staff verbalizing increased concerns during patient interactions, staff were reporting practice changes to avoid patients they felt were agitated. A deficiency in staff on identification, mitigation and de-escalation of these patient behaviors (Bruccoli, 2023) was noted. The team evaluated best practices locally, regionally and within current literature, concluding that the implementation of a Behavioral Emergency Response Team (BERT) would be ideally suited to reduce workplace violence (Parker, et al. 2020).
Literature review identified the consistent effectiveness that BERT Teams demonstrated to decrease behavioral emergencies, workplace violence and staff injuries. We shifted our focus to underlying medical causality for behavioral emergencies rather than intentional conduct. We reviewed current practices and available resources to attain our goals of decreased workplace violence. This showed that specially trained staff were critical to BERT success and we hired additional mental health technicians in response.
A comprehensive education plan was developed that included Crisis Prevention (CPI) training, de-escalation and mitigation training, simulation-based courses and mock BERT drills prior to implementation.
Since deploying Code BERT in October of 2024 there has been a decrease in Type two Workplace Violence incidents towards staff. Prior to BERT initiation the eight-month average for incidents for 2024 was 8.8 with a rate of 12.46/1000 patient days. Post-initiation, our four-month average dropped to 4.25 with a rate of 3.99/1000 patient days. Our staff report increased confidence when interacting with patients experiencing behavioral emergencies, feeling that their voice was heard and reassured that they can call a specially trained team when assistance is needed.
In assessing post-deployment resource utilization, there has been a decrease in all workplace violence incidents, specifically Code BERT activations coupled with a decrease in code purples from 18 to three indicated a tailored approach to targeted medical management of behavioral emergencies. Focused treatment of medically induced behavioral changes provides patients earlier intervention, decreases agitation and potentially decreases length of stay when medically comorbid issues are treated earlier.
Description
Workplace violence incident increases, nationwide staff injuries and increased patient agitation were contributing to patient avoidance. A Behavioral Emergency Response Team (BERT) was implemented utilizing a comprehensive education plan to decrease workplace violence while focusing on medical causality. Post implementation we have seen a pointed decrease in workplace violence; staff have expressed confidence during interactions and earlier medically induced behavioral emergencies.