The Aggression Risk Score is a prognostic tool used to identify patients with high risk of developing aggression episode during their hospital LOS, therefore helping to shift the practice towards preventive paradigms, improving patient safety, and minimizing cost of care. The project was deployed on February 2023 at Mount Sinai Hospital.

Challenges

Patient Aggression is one of the most complex and dangerous occupational hazards in healthcare environment
- Patents are subjected to more restrictive intervention => High cost and resource utilization
- Increasing stress and tension on both patients and providers
Patient aggression is not strictly limited to acute psychiatry units
The most common aggression management tools are including:
- Broset Violence Checklist
- Violence Risk Assessment Scheme
- McNeil-Binder Violence Screening Checklist
The current aggression management tools
- Limited prognostic value: golden time (time between initiation of aggression and intervention) is ~ zero

BROSET Violence Checklist

Nursing-administered screening tool to predict potentially aggressive patients

Patients get rated on six factors:

- Confusion
- Irritability
- Boisterousness
- Verbal threats
- Physical threats
- Attacking objects
Scores greater than or equal to 2 indicate the potential for high risk of violence in the next 24 hours
Triggers a consult to psychiatry focused on:
- De-escalation
- Behavioral strategies
- Psychiatric assessment