Behavioral Escalations — Alert Team Safe — Clinical Pathway: Outpatient Specialty Care and Primary Care

Behavioral Escalations Clinical Pathway — Outpatient Specialty Care and Primary Care

Alert Team Safe

If a patient has a Behavioral Safety Alert in place, teams should review the information provided prior to the patient appointment to ensure necessary staff and resources are available to complete care. In the event that an alert is not present or the patient/ parent presents with unexpected behaviors, consider the following recommendations.

Please consider reviewing Offsite Team Safe Response Procedure.

Alert Method and Considerations

Initial Staff Notification may look different at each ambulatory location. Teams should follow the standard response for any code event when considering notifying staff of a behavioral emergency.

Staff involved in escalation, or Response Initiator should utilize cisco phone, hall phone or other resource available to contact colleagues for support. Response initiator should communicate the following:

  • Reason for call, age of person escalating, room number or location descriptors, and any other pertinent details.
  • Staff will call 911, if needed.

Staff Roles and Responsibilities

Response Initiator

Initiation Phase Response Phase Recovery Phase
  • Determines a local response is required and initiates a Team Safe alert
  • Stays and attends patient/person of interest
  • Provides responding staff with a situational assessment including:
    • Person of interest’s needs
    • Disposition
    • Medical/physical/behavioral issues, etc.
  • Is available as needed in response
  • Participates in staff debrief following incident

Team Leader

Initiation Phase Response Phase Recovery Phase
  • Receives the situational update from the Response Initiator
  • Begins to assess needs of the incident and assigns tasks to the responding team members
  • Takes ownership of the crisis
  • Maintains global awareness
  • Serves as point person for communications
  • Takes lead in decision-making:
    • Assesses the situation
    • Plans the intervention
    • Decision making
    • Communication
    • Safety
    • Postvention approaches
  • Contacts or designates someone to contact 911 and requests an ALS ambulance to facilitate transfer if necessary
  • Completes KAPS report
  • Completes staff debrief following event
  • Contacts family for debrief 1-3 days post event

Family Supporters

Initiation Phase Response Phase Recovery Phase
Once receiving situational update from the Team Leader, responds to caregiver needs
  • Supports the person of interest’s caregivers
  • Siblings
  • Notifies others in the area that a response is occurring
  • Including other patients/providers
 Participate in staff debrief following incident

Traffic Controllers

Initiation Phase Response Phase Recovery Phase
Once receiving situational update from the Team Leader moves to locations to minimize the risk of elopement or redirects patient care traffic
  • Monitor hallways
  • Direct traffic
  • Keep access to the room unobstructed
  • Provide perimeter security
 Participate in staff debrief following incident

Safety Champion, Other Responders

Initiation Phase Response Phase Recovery Phase
Once receiving situational update from the Team Leader moves to assigned tasks such as calling 911, making the environment safe
  • Assists where possible at the direction of the Team Leader
    • Clears room/area of safety hazards
  • Contacts 911
  • Gathers demographics if the patient will be going to the hospital
 Participates in staff debrief following incident