Reducing Employee Injuries from Aggressive Patient Behavior at Children's Hospital by Implementing a Behavioral Response Team.
A rapid-response behavioral team halved staff injuries from pediatric patient aggression without new safety gear.
01Research in Context
What this study did
JJackson et al. (2025) set up a Behavioral Response Team at a children's hospital. The team responds when a patient becomes aggressive. They tracked staff injuries before and after the team started.
The study looked at injury rates per 1,000 patient visits. They compared one year before the team to one year after.
What they found
Staff injuries dropped from 3.4 to 1.7 per 1,000 visits. Days between injuries grew from 163 to 271. The team cut injury rates in half within a year.
No new safety gear or drugs were added. The change came from how staff responded to aggression.
How this fits with other research
Cervantes et al. (2019) and Mae Simcoe et al. (2018) showed that hospital-wide autism care pathways can keep restraints low for 18 months. JA's BRT builds on this idea but targets staff injuries rather than restraints.
Pugliese et al. (2021) used feedback to boost PPE use in schools and also cut staff injuries. Both studies show that simple staff-focused plans beat new equipment.
Logue et al. (2025) used a review panel to cut restrictive procedures by 80%. JA's BRT achieves similar safety gains through rapid on-floor response instead of paperwork.
Why it matters
If you work in a hospital, school, or clinic where clients hit, kick, or bite, you can copy the BRT model. Train a small rotating team to respond to aggression using behavior skills, not force. Track injuries before and after. One year of data may be enough to show your bosses the plan works and keeps staff safe.
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Pick two staff per shift to be the 'go team' for aggression calls and give them a one-page response script.
02At a glance
03Original abstract
<h4>Background</h4>Among hospitalized children, episodes of aggressive patient behavior place healthcare staff at risk for serious injuries. By implementing a behavioral response team at a children's hospital, we aimed to reduce monthly employee injuries related to aggressive patient behavior from 3.4 to 2.4 per 1,000 acute care visits during 12 months.<h4>Methods</h4>At a children's hospital, a multidisciplinary team used quality improvement methodology to implement a behavioral response team that provided proactive and reactive support to staff caring for children at risk for aggressive behavior. Full-scale implementation occurred in July 2022. We measured days between Occupational Health and Safety Administration (OSHA)-recordable employee injuries related to aggressive patient behavior and total monthly employee injuries related to aggressive patient behavior per 1,000 acute care visits (emergency department visits and/or hospitalizations) by patients 3 years of age or older.<h4>Results</h4>In the year after full-scale implementation, an average of 101 BRT rounds and 17 reactive responses occurred per month. The maximum number of days between OHSA-recordable employee injuries related to aggressive patient behavior increased from 163 days in the year before full-scale implementation to 271 days in the following year. Monthly employee injuries related to aggressive patient behavior decreased from 3.4 to 1.7 injuries per 1,000 acute care visits by patients 3 years of age or older.<h4>Conclusions</h4>The BRT model, which provides proactive and reactive support to hospital staff caring for children at risk for aggressive behavior, should be considered a strategy to reduce employee injuries and promote workplace safety.
, 2025 · doi:10.1097/pq9.0000000000000790