Behavioral Emergencies Across the Lifespan

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Method: Data on all behavioral emergencies that occurred at the UVA Medical Center from ‎January 2020 to December 2020 were collected. UVA Medical Center is a level 1 trauma center that ‎includes an adult and children’s acute care and intensive care hospital. Variables collected include ‎patient demographic information (e.g., age, gender assigned at birth), time of behavioral emergency, ‎frequency of behavioral emergency, type of behavioral emergency, factors contributing to behavioral ‎emergency, and whether the C-L Psychiatry service (adult or pediatric) had been consulted. Patients ‎will be grouped by age (pediatric, young adult, middle-aged, older adult) and compared on the above ‎variables to identify potential differences among the age groups.‎

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Results: Previous reported data show that UVA Medical Center had an average of 61.2 (range ‎‎38-82) behavioral emergencies per month between January 2020 and December 2020. These fell into ‎five categories consistent with previous pilot data: physical aggression, leaving the unit, verbal ‎aggression, agitation, and non-compliance3. Data will be further analyzed to determine how ‎frequently patients in each age group exhibit initial behavioral emergencies and repeat behavioral ‎emergencies and time of day of behavioral emergency. Additional analyses will be conducted to ‎determine differences among these groups on type of behavioral emergency, factors contributing to ‎behavioral emergency, and whether pediatric or adult C-L Psychiatry services had been consulted.‎

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Discussion: This data will identify differences across the lifespan in the occurrence of ‎behavioral emergencies and several important factors related to behavioral emergencies, including ‎type of behavioral emergency and the factors that contribute to behavioral emergencies. It will inform ‎how proactive intervention and management efforts led by C-L Psychiatry services need to be ‎modified based on patient age group to increase effectiveness. Future directions will be discussed.‎

‎Conclusions/Implications: The findings from this quality improvement project have important ‎clinical implications related to proactive intervention and management of behavioral emergencies and ‎how these strategies may differ across the lifespan.‎

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References: ‎
‎1. Lanctôt N, Guay S. The aftermath of workplace violence among healthcare workers: A systematic ‎literature review of the consequences. Aggress Violent Behav. 2014; 19(5):492-501.‎
‎2. Speroni KG, Fitch T, Dawson E, Dugan L, Atherton M. Incidence and cost of nurse workplace violence ‎perpetrated by hospital patients or patient visitors. J Emerg Nurs. 2014; 40(3):218-28.‎
‎3. Yost, J., Pachano, G., Cavanagh, C., Smith, J., & Njoku, I. (2022). Behavioral Emergencies in the ‎General Hospital: Role of CL Psychiatry in Early Management and Prevention. Journal of the Academy ‎of Consultation-Liaison Psychiatry. 2022; S108-S108.‎