A patient safety flag is an alert within the Epic banner that notifies staff that the patient is potentially a safety risk due to a history of violent/threatening behavior. The flag signifies that caring for the patient requires heightened safety awareness. An acute care plan will accompany any flag placed at Brigham and Women’s Faulkner Hospital and describes steps staff can take to maintain safety specific to the patient.
Please keep in mind that the flag itself is only an early alert for staff of a potential history of threats or violence. It is a “heads up” to signal to the care team that the patient has had a significant safety issue in the past. Having a flag placed in a chart will not, by itself, make staff safer. Working together on the unit or in the department to proactively plan for patient containment and for staff protection is the best way to maintain safety. Additionally, the flag does not mean that the patient must have a security 1:1. Each patient will be assessed by the local care team for current status and a plan will be made for safety. Many of the patients that we treat with safety flags placed from other hospitals have been calm and cooperative when in our care.
A patient that has exhibited very serious escalating behavior that is intimidating, threatening, dangerous or potentially dangerous, and poses a risk of harm to others can be reported by any staff person for review by the Flagging Group.
Appointed members from Security, Risk Management/Patient Safety, Psychiatry, Social Work, Inpatient Nursing and the Emergency Department gather to determine if a patient meets the criteria for a safety flag. Flags are also reviewed by this same group every six months to determine whether it is appropriate to remove or continue the safety flag. Flags are only removed if there is significant time and circumstance that changes the risk previously identified. Once a patient has been flagged, they are sent a formal letter by Security notifying them that there is a safety flag placed in their chart based on an event and/or the patient’s behavior.
Submit a Safety Report into the online safety reporting system, RL Solutions, and describe the patient’s history of threatening or violent events and request evaluation of a safety flag. The reporter or the department reviewing the safety event can directly request that the patient should be considered for placement of a safety flag.
An acute care plan provides guidance about how to best manage and care for a patient who has potential for a violent/threatening event. Suggestions may include recommendation for Security presence or specifics as to triggers or treatment that apply to the patient. Psychiatry and ED physicians on the flagging group create the acute care plans based on clinical information about the patient.
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