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National Development and Implementation of a Democratized Disruptive Behavior Reporting System in Health Care

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Abstract

Introduction

Workplace disruptive behavior/ violence (WDBV) is underreported in health care. This study evaluated a 7-year implementation of the Disruptive Behavior Reporting System (DBRS), the most robust consolidated WDBV reporting system developed in the United States within the Veterans Health Administration (VHA).

Methods

After implementation of the system, implementation success was measured in real time by number of reports, types of staff entering reports, time to review the reports and time between when the incident occurred and report entry.

Results

Over the seven years since implementation, there has been a significant increase in reporting within DBRS with more than 50,000 reports in fiscal year (FY) 2021 up from 0 to 2014. Types of staff reporting increased to 67 from 54. The median number of days to review events in FY19 Q2 was 4.79 days and the report latency has almost completely disappeared.

Discussion

DBRS was designed to democratize reporting so staff can report WDBV anytime and anywhere playing a large role in the successful implementation. The increase in total number of reported events is an indication of the success of the system as it captures data historically lost due to underreporting.

Conclusion

DBRS development and implementation showcases how information systems can empower front-line personnel to voice behavioral safety concerns.

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Data Availability

The dataset used in this research are available as part of the government database maintained through the VHA Office of Quality and Patient Safety, Office of Analytics and Performance Integration, VHA Support Service Center.

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Authors and Affiliations

  1. Workplace Violence Prevention Program, VHA CO, Office of Mental Health and Suicide Prevention (11MHSP), 2763 Queenswood Dr, Cincinnati, Oh, 2763, USA

    Scott Hutton

  2. Workplace Violence Prevention Program (WVPP), Office of Mental Health and Suicide Prevention (11MHSP), Veterans Health Administration , Lexington , USA

    Kelly Vance

  3. VHA Office of Quality and Patient Safety (QPS), Office of Analytics and Performance Integration (API), VHA Support Service Center (VSSC), Veterans Health Administration, Baltimore, USA

    Shawn M. Loftus

  4. Office of Analytics and Performance Integration (OAPI), Center for Strategic Analytics and Reporting (CSAR), Veterans Health Administration, Cincinnati, USA

    Greg Roth

  5. Workplace Violence Prevention Program (WVPP), Office of Mental Health and Suicide Prevention (11MHSP), Veterans Health Administration, Vancouver, USA

    Lynn M. Van Male

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  1. Scott Hutton
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  4. Greg Roth
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Contributions

Scott Hutton, Shawn Loftus, Greg Roth wrote the main manuscript text. Kelly Vance prepared Fig. 2 and did the data analysis. Lynn Van Male prepared Fig. 1 and did the final editing. All authors reviewed the manuscript.

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Correspondence to Scott Hutton.

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Hutton, S., Vance, K., Loftus, S.M. et al. National Development and Implementation of a Democratized Disruptive Behavior Reporting System in Health Care. J Med Syst 47, 104 (2023). https://doi.org/10.1007/s10916-023-01999-0

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