The Team Approach to handling potentially violent situations and confrontations in the health care environment

LETTER OF INTRODUCTION

Over the past twenty years hospital violence has increased substantially resulting in increased staff and patient injuries. In addition, lawsuits have followed with the awarding of millions of dollars to plaintiffs in litigation by the courts. It has been also determined through recent studies that Hospitals are the number one crisis prone industry in the United States.

Emergency health care cannot be administered should staff themselves get injured. The personal protection and safety of all hospital employees is a major concern, critical to us all and is the purpose of this training program.

The Crisis Management Response Team (CMRT©) program has been designed and developed as a "total hospital system" for staff that has the potential to treat and handle hostile, violent patients, family members and visitors at the hospital. The CMRT concept is a unique team approach to handling potentially violent situations and confrontations. The program is designed to put into place a skilled and competent team, to immediately respond to any crisis that may occur in the hospital, with the purpose of assuring the highest degree of safety possible to all staff, patients, visitors and vital hospital equipment.

The training will be physically and mentally demanding, as in all situations where one must control and deal with violence. Your utmost attention is required and necessary in this training program. We are confident that you will find the training exciting, and most important, you will have a greater sense of confidence in handling these often dangerous and critical situations that have and continue to plague the health care system.

Thomas J. Archambault, President - Chief Instructor
TJA Protect-Systems-International & TJA Use of Force Training, Inc.

COURSE BEHAVIORAL OBJECTIVES

1. To have CMRT Members understand the causes of hostile, confrontational and violent behavior.
   
2. To fully comprehend the TJA Ladder of Force and its purpose for CMRT responses to de-escalate use of force conditions, and for documentation purposes to hospital administration.
   
3. To be able to recognize and identify specific causes of pre-violence, violent behavior and hysteria when dealing with visitors and patients in the hospital.
   
4. To possess the knowledge and skills of specific environmental concerns, dangers and the active measures that can be taken to prevent injury to staff, patients and visitors.
   
5. To be able to recognize and identify the four specific types of anger, and have an understanding of the intoxication/medical effects on anger.
   
6. To be able to communicate key verbal skills through de-escalation techniques for the prevention of use of physical force.
   
7. To have the knowledge and necessary skills to know when to escalate to physical force and to control a potentially violent situation or confrontation.
   
8. To possess the knowledge and skills in the use and concepts of the Emergency Response Belt for CMRT Responses.
   
9. To be able to properly execute the use and applications of restraints in various situations, which may be required in the control, and restraint of violent patients.
   
10. To have the necessary knowledge and skills to handle any crisis, which may occur in the hospital with the utmost professionalism.

INTRODUCTION TO THE CMRT TRAINING CERTIFICATION PROGRAM

The CMRT Training Program has been constructed in five specific levels of training:

1. Lecture.
   
2. Note taking from personal notes and the use of a Workbook.
   
3. Hands-on Physical Training from both passive and aggressive situations and scenarios.
   
4. Training Manual and Workbook compilation based on 1-3.
   
5. Written and Practical Examinations.
   

The course will consist of a majority of hands-on exercises, drills and scenarios both in the classroom and in various locations in the hospital.

It is extremely important to take notes, ask questions and actively participate in the hands-on training where physical skills are required and demanded. The control and restraint of any violent person can be successfully obtained in some cases with verbal skills. The overall concept of this training program is the effectiveness of a "team response." A combination of five members interact where both the verbal skills of the team leader and the physical skills of the team members handles the situation, effectively, judiciously and with the utmost professionalism.

Team interaction is the core of the program. Think team, act team and be a team.