Comparison of violence risk screening experiences of emergency department clinicians.

Objective: Individuals commonly present to the emergency department (ED) for care after violence and many are also at risk for subsequent self or other-directed violence. Screening for violence risk represents an important part of ED care, but is challenging to implement effectively. Feedback from ED providers is needed to characterize differences across provider types in order to facilitate implementation of enhanced screening practices.

Methods: This qualitative focus group study examined the experiences of 6 psychiatric social workers, 16 emergency medicine physicians, and 15 psychiatric providers in conducting violence risk screening to elicit ideas about solutions and barriers.

Results: Eight themes emerged: Approach to Patient Assessment, High-Yield Clinical Data in Risk Assessment, Suicide Risk Screen, ED Clinician Resources, Analysis of Professional Risk, Affective Response of Clinician, ED Role and Scope, and Clinical Management. All clinician types discussed the themes from their professional perspectives and generated important knowledge of violence risk screening practices.

Conclusions: The findings affirm the importance of interdisciplinary cooperation in addressing violence risk in the ED and emphasize the need for ongoing clinical education and feedback as well as the importance of optimizing efficiency.