Current Best Practices for Managing Agitation and Workplace Violence: Mastering Coordinated Responses, De-escalation Strategies, and Medication Proficiency (ADIEM and Behavioral and Psychological Interest Group Sponsored)

Dr. Wong is a physician-scientist in the Department of Emergency Medicine, with a focus on teamwork, patient safety, behavioral health, and healthcare disparities. He is the Research Director and Associate Fellowship Director at the Yale Center for Medical Simulation. He also has expertise in qualitative and mixed-methods techniques for health services research.

He received his Bachelor of Science from the University of British Columbia in Microbiology & Immunology in Vancouver, Canada and attended Washington University School of Medicine in St. Louis, Missouri. Ambrose obtained his Emergency Medicine residency training at NYU & Bellevue Hospitals Center in New York City, serving as chief resident physician in his final year. He subsequently completed a medical simulation fellowship at NYU School of Medicine & New York Simulation Center for the Health Sciences. He received a Master of Science in Health Professions Education at Massachusetts General Hospital Institute of Health Professions.

Dr. Wong applies healthcare simulation technology to address workplace violence and improve behavioral care in the emergency setting. He has authored 25 peer-reviewed publications on behavioral emergency care and received an NIH NCATS KL2 & YCCI Scholar Award to implement an agitation code team response intervention. He is the current recipient of multiple federal awards to investigate the use of health IT and patient-centered methods to improve the care of agitation management while maintaining safety of staff and healthcare workers.

Alice Kidder Bukhman is an Instructor of Emergency Medicine at Harvard Medical School and faculty in the Department of Emergency Medicine at Brigham and Women’s Hospital (BWH). Her research and operational work focuses on program development, operations and health equity in both the U.S. and global context. She currently serves a Medical Director for Brigham and Women’s Faulkner Emergency Department and Head of Medical Partnerships for Prisoners’ Legal Services of MA.

Dr. Im is a board-certified emergency physician who serves as the Director of Quality and Safety for Mass General Brigham (MGB) Enterprise Emergency Medicine. She chairs the MGB Emergency Medicine Quality and Safety Council and also holds the position of Director of Quality and Safety in the Department of Emergency Medicine at Brigham and Women's Hospital. In these capacities, she leads emergency medicine-related quality improvement and patient safety initiatives across MGB Enterprise Emergency Medicine, which consists of 9 emergency departments. As the Director of Behavioral Health, she oversees the Behavioral Health Observation Unit—a specialized observation area for behavioral health patients awaiting evaluation, treatment, and disposition in the ED at Brigham and Women's Hospital.

Dr. Im's grant-funded work involves conducting qualitative analyses of patient and staff perceptions of behavioral health emergency care within the ED setting, developing systems-level de-escalation strategies, and implementing antiracism and trauma-informed simulation-based interdisciplinary de-escalation training programs across multiple EDs. Moreover, her research interests focus on implementing interventions to convert boarding time into treatment time for patients with behavioral health emergencies.

Dr. Gina Lopez is a board-certified Emergency Medicine physician working at Boston Medical Center, the busiest emergency department in New England. With a large safety net population, she works with the Multi-Visit Patient Program which strives to meet the complex care needs of the most vulnerable, frequent visitors both in the ED creates bridges to services in the community. She is highly committed to the diverse patient population, as well as cultivating diversity within Emergency Medicine through work with the Justice, Equity, Diversity and Inclusion group which creates a sense of community amongst those who have faced barriers practicing medicine.

Serving as the Physician Director of Workplace Safety, she collaborates with leaders across the hospital system from nursing, public safety, behavioral medicine and patient advocacy to coordinate care for patients with behavioral challenges prioritizing patient and staff safety. Dr. Lopez championed the roll out of utilization of standardized agitation scoring across the hospital system. She has been a partner in the development the hospital’s Behavioral Response Team working towards early response systems to agitation management, bedside support and prevention of crisis incidents. Partnering with Public Safety, she chairs the hospital Threat Assessment Team and Safety Care Plan Committee reviewing all safety incidents in the hospital and prioritizing care plan development to bring trauma-informed safety recommendations to frontline care providers. Working with Quality and Safety, she reviews workplace violence safety incidents, leads investigations and coordinates root cause analyses for critical events.

She is proud to be involved in efforts to improve hospital policy, staff education and strategic planning for prevention and mitigation of workplace violence. Her special interests include emergency behavioral care, effective de-escalation, workplace safety, health equity and staff wellness.

Dr. Casey Clements is a Consultant Physician and Associate Professor of Emergency Medicine at the Mayo Clinic in Rochester, Minnesota. He serves within Mayo Clinic Quality as the Staff Safety Officer, leading Environmental Health and Safety for the Mayo Clinic Enterprise and an operational Occupational Safety team based in Rochester, MN that is responsible for an integrated safety management system and its many programs working throughout Mayo Clinic on staff injury prevention and response. His own work in this area focuses on healthcare-based violence mitigation. Having helped lead workplace violence mitigation efforts for Mayo Clinic since 2014, he now chairs the Complex Behavior Committee for both the Rochester practice and the Mayo Enterprise which spearheads efforts to address violence in healthcare. Dr. Clements also has a Ph.D. in Microbiology & Immunology and his additional interests include research in the areas of emergency infection and sepsis, as well as ED operations, and opioid stewardship.

Dr. Martel is a Professor of Emergency Medicine at the University of Minnesota and a has been a nocturnist at Hennepin County Medical Center for more than 25 years. He has extensive experience in critical care and emergent psychiatric issues. His peer-reviewed research includes topics on emergency airway techniques, management of acute agitation and sedation.

Dr. Wilson is board-certified in Emergency Medicine and Addiction Medicine, and is an Associate Professor (tenured) in the Departments of Emergency Medicine and Psychiatry at the University of Arkansas for Medical Sciences. He serves as the current Chair of the Coalition on Psychiatric Emergencies (coalitiononpsychiatricemergencies.org), Secretary of the Board of Directors for the American Association for Emergency Psychiatry (www.emergencypsychiatry.org), and as Senior Associate Editor of the Journal of Emergency Medicine (www.jem-journal.com). Clinically, he serves as the emergency department lead for neurological emergencies, psychiatric emergencies, and substance use disorders. Dr. Wilson’s research in behavioral emergencies and substance use disorders have been cited more than 4150 times (h-index 32), and he has written more than 90 peer-reviewed articles, 30 book chapters, and 4 edited books. His work has been supported by numerous federal and private grants, and has been recognized as innovative by the American College of Emergency Physicians and the American Foundation for Suicide Prevention

Dr. Vrablik completed her emergency medicine residency at Indiana University in 2012. She then completed a Masters in Clinical Research in 2014. Her research interests are in workplace violence, patient and provider safety and quality improvement. Her research interests are in workplace violence, patient and provider safety and quality improvement. Currently, she is an associate professor of Emergency Medicine at the University of Washington in Seattle, WA. She is the medical director of the UW-Montlake ED. Dr. Vrablik has served as the Principle Investigator for a grant funded by the Safety and Health Investments Projects program through the Washington Department of Labor and Industries to investigate the impact of workplace violence on emergency department healthcare workers in the Puget Sound area. She has also been a primary author on a report that provided a framework for hospital administrators and leaders around preventing and mitigating WPV and its impacts on employees. She has served on expert panels on WPV prevention and mitigation in healthcare at national meetings. She is an elected member of the UW Medicine committee for WPV Prevention.

Michelle Suh, MD (she/her) is an emergency medicine physician, educator, and researcher. She completed her medical education and residency training at the Baylor College of Medicine, and she is currently a medical education fellow at the University of Chicago. Her research interests focus on the hidden curriculum of medical education and caring for vulnerable populations.

Bidisha Nath, MBBS, MPH - is an Associate Research Scientist and Health Services Researcher in the Department of Emergency Medicine at Yale School of Medicine.

Dr Nath has a background in Medicine, Public Health and Psychiatry. Her research focuses on patient centered approaches of improving Mental Health Outcomes in the Emergency Department and includes innovative healthcare delivery models, use of trauma informed care in the ED, and quality improvement and measure development towards improving staff safety, patient experience and outcomes for patients with mental health outcomes in the ED. She works closely with dr Ambrose Wong, MD and his lab across multiple projects that focus on patient centreded way of management of Behavioral Health Crisis in the ED.

At SAEM 2024, she will be presenting with Drs Wong, Im and others on "Current Best Practices for Managing Agitation and Workplace Violence: Mastering Coordinated Responses, De-escalation Strategies, and Medication Proficiency"

Contact/Email: bidisha.nath@yale.edu