ISSN: 1522-4821



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Model for Assessing Disruptive Behavior in the Medical Setting: Pilot Study of Provider Satisfaction

Jennifer Piel, JD, MD

Background: Risk assessment of future disruptive and violent acts is of great importance to public protection and care in the medical setting. The VA Puget Sound, Seattle, is utilizing clinical forensic risk evaluations in its assessments of veterans with disruptive Patient Record Flags or at elevated risk for violent behavior. Aim: To assess and compare provider knowledge, experience, and satisfaction with the clinical forensic risk assessment through the facility's Disruptive Behavior Evaluation Clinic. Method: A pilot internet-based survey was constructed to evaluate provider characteristics, experience, and satisfaction with a new Disruptive Behavior Evaluation Clinic. Members of the hospital's Disruptive Behavior Committee and mental health service lines were asked about their familiarity and confidence in the consultative service. Results: Forty-four providers responded. Of these, 23 providers were familiar with the Disruptive Behavior Evaluation Clinic and its clinical forensic risk assessments. All members of the facility's Disruptive Behavior Committee were familiar with the risk assessments. Members of the Disruptive Behavior Committee as well as clinical providers from the mental health service lines ranked highly the utility of the detailed risk assessments and risk management recommendations. Conclusions: The provider satisfaction survey provided evidence for the overall satisfaction with the use of clinical forensic risk assessments in VA facilities for assessment and management of persons with Patient Record Flags and other indicators of elevated risk of disruptive or violent behavior at one VA hospital.