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Westchester Behavioral Health Center improves staff and patient safety

Patient aggression can be common in psychiatric settings and incidences of verbal and physical violence toward staff have significantly increased in recent years. In 2021, the Westchester Behavioral Health Center (a member of NewYork-Presbyterian) initiated a pilot program to reduce the growing number of patient assaults of staff and reduce overall acuity at their psychiatric intensive care unit.

The pilot was co-led by Rebecca Emmanuelli, patient care director, and Jimmy Avari, MD, unit chief of the PICU. Beginning mid-summer 2021, interdisciplinary meetings were led by executive staff to develop the three-month pilot program. The pilot began Nov. 1, 2021, on a section of Unit 5 South, where patients with aggression, violence and incarceration histories are treated for acute psychiatric stabilization. As part of the pilot, several tailored interventions were tested, including:

  • individualized behavioral care plans to target specific behaviors;
  • minimizing stimulation;
  • providing 1:1 with psychology interns;
  • art and music therapy; and
  • strategic staffing: four staff for every five patients to ensure all needs were met in a timely manner.   

Unfortunately, due to the rise of COVID-19 cases, the pilot ended one month early. However, the cohesiveness of the PICU team led to a successful pilot. Data show that during the pilot the facility had one patient-to-patient assault (no injury), one patient-to-staff assault (minor injury), one safety watch that ended within a few hours and only a few episodes of restraint (manual/mechanical) and seclusion. Since COVID-19-positive admissions have decreased, the team will soon bring the unit back permanently.

For more information, contact Rebecca Emmanuelli, MS, BSN, BS, RN, PMH-BC, NEA-BC, patient care director, at ree9011@nyp.org or 914.682.9100 ext. 682-5459.