The New York Presbyterian Hospital (NYP) used its Center for Prevention Programs and Partnerships (CP3) Targeted Violence and Terrorism Prevention (TVTP) grant funding to provide tailored behavioral threat assessment and management (BTAM) training and train-the-trainer awareness briefings to security staff and physician.
NYP received its initial CP3 TVTP grant in fiscal year 2020 to develop and deliver workplace violence prevention, de-escalation, mental health first aid, and targeted violence prevention training to security staff and physicians in dozens of hospitals and centers in the Greater New York City area.
The New York Presbyterian Hospital training team refined the content and delivery methods of the targeted violence and training curriculum to better reach both unarmed security staff and clinicians who were exposed to workplace violence.
NYP has a long-documented, high rate of workplace violence—primarily between patients and hospital staff. Although the NYP training team intended to offer relevant trainings in signs of radicalization to violence, active shooter awareness, and awareness of TVTP in the first six months of the project, the COVID-19 pandemic greatly limited its ability to conduct in-person training and reduced the availability of staff for training. Additionally, workplace violence grew significantly worse during the pandemic, forcing training teams to rethink their strategy.
The New York Presbyterian Hospital Training Team refined the content and delivery methods of the Targeted Violence Training Curriculum to better reach both unarmed security staff and clinicians who were exposed to workplace violence.
NYP conducted its first annual hazard vulnerability assessment to identify gaps in preparedness and drive curriculum refinement in 2020. The results established that the current de-escalation training had limited effect because of the unique hospital environment, which included that hospital staff were expected to provide protection and care; NYP security staff are unarmed; many patients have limited mobility; doors rarely have external locks; and the environment is generally not conducive to Run. Hide. Fight.™ tactics.
NYP updated its curriculum, adding “ABC” (avoid, barricade, or confront), which allows staff to provide care to patients while reducing the risk of harm. After comparing the training curriculum to rates of incidents that were reaching the NYP BTAM, the NYP trainers removed classroom-style de-escalation and active-shooter content that did not have the desired impact with clinicians. Instead, NYP trainers conducted “walk-and-talk" onsite functional exercises with physicians and security staff. NYP also partnered with local law enforcement to conduct live drills and offer feedback in the hospital rooms, allowing physicians and security staff to apply training to real-life situations. NYP also partnered with the volunteer ambulance corps and houses of worship to provide public safety training and tailor the training for community members based on requests.
As a result, NYP facilitated mental health first aid training for approximately 50% of the current security staff across all campuses. Newer security staff continue to be trained within their first days or weeks of employment. Anecdotal evidence suggested that walk-and-talks, digital content, and training videos are better ways to reach clinicians.