Caring Wisely FY 2025 Project Contest

4 Comments

Lowering the Flag: A Harm Reduction Approach to Patient Behavioral Alerts

Proposal Status: 

Behavioral alerts (BAs, “FYI flags” at UCSF) are the predominant way employees communicate risk for violence or aggression across patient care encounters and settings. However, there is limited data to support their use as violence prevention tools, and they may cause patient harm through the promotion of biased care and denial of care resources. UCSF does not have a policy to guide the use or placement of FYI flags nor a program to actively approach clinicians and staff after patient behavioral incidents to provide support and education. The FYI Flag workgroup at UCSF was formed to create the FYI flag policy and centralize the writing of FYI flags in an effort to remove stigmatizing or inappropriate language within the flags and reduce the potential for their biased application. The aims of this proposal are 1) to ensure FYI flags are placed only for events that violate UCSF’s violence and harassment policies 2) to work with Epic to alter the structure of FYI flags to increase their effectiveness as violence prevention tools and limit their ability to cause patient harm 3) to provide targeted outreach and support to clinicians and staff after behavioral incidents to promote employee safety and comfort in the workplace and equitable patient care.

Comments

So excited to see this work being proposed. Addressing these flags is vital to assure we're providing unbiased care across all contexts. 

An incredibly important topic! The language in these flags is so important in addition to even the experience of opening a chart and immediately getting a brightly colored flag-sometimes they stem from instances that happened years ago and I wonder how these immediately biases anyone opening the chart, even if your own experience with the patient has differed. 

I love this project. The red flags need to be re-evaluated to promote equitable care. Thanks for proposing this!

Such an important work effort to improve the equity and quality of care for our patients, excited to see this proposal!