Table 2.

Summary of program evaluation meeting with emergency department managers and educators (n=6).

1. Overall, how beneficial do you believe the violence prevention program was in reducing violence?  a. All managers and nurse educators verbalized their beliefs that the program was beneficial in reducing violence in their departments.  b. The classroom training was rated particularly high with all managers and stated overall compliance was good.  c. Physician participation was very low in two emergency departments. One manager identified that the environmental changes were the most important and beneficial component.

2. Discuss your ability to adapt and follow the new workplace violence prevention policies.  a. One manager stated that it was initially a challenge with another stating that the program was slow getting adopted.  b. There were several comments about the need for increased administrative and physician support for the changes.  c. One manager commented that the new policies and procedures led to increased dialogue about workplace violence.

3. To what degree did your emergency department comply with the new workplace violence prevention policies and procedures?  a. The managers uniformly stated overall compliance was good with compliance really depending on the particular intervention subcomponent.

4. To what degree did your emergency department comply with each of the specific intervention components and subcomponents?  a. Environmental changes were perceived as effective by all managers and nurse educators.  b. On-line training was generally characterized as being too long with technology issues that were challenging for some clinicians.  c. Classroom training was well liked. Only one emergency department had physician participation and support.  d. Lobby rounding to assess for risks varied depending on the department, component, and individual employee and staffing. For example, while lobby rounding was viewed as important, managers stated that compliance depended on patient capacity and staffing.  e. Screening patients for early signs of potential escalation was being used and found to be helpful, but not as intended with too many patients being flagged.  f. Asking about a concealed weapon during triage varied among the ED clinicians and their comfort level in asking. Weapons were turned over by patients in all three emergency departments.  g. Flagging patients with a history of violence or exhibiting signs of potential violence was consistently used by all emergency departments.  h. Levels of awareness to alert employees of violence risk level in the ED was the most difficult intervention for clinicians to understand and generally was not being used.  i. The violent event response procedure and table was determined to be helpful to aide clinicians identify specific actions. The table added as a name badge card was not found to be helpful or used by the clinicians.  j. Care after a violent event was done consistently if managers became aware of the event. Some reported discussing events at meetings.  k. Reporting a violent event remains a problem with clinicians providing reasons for why they do not report violent events.  l. Post-incident review using a root cause analysis process for more severe violent events was consistently performed by managers.

5. How would you rate the partnership between academia and hospital emergency departments?  a. Evaluated as positive uniformly by all managers though sometimes challenging when priorities at the emergency departments and hospitals conflicted with the project.