Managing patient aggression during registration: in preparation of implementing Affordable Care Act (ACA) 1557 intake questions

Health professionals face high rates of workplace violence from patients. This study systematically informed registration staff about pre-violent behaviors and tested its impacts on staff approaches to aggression. In this study, staff were concerned that the implementation of the new patient registration questions as mandated by the Affordable Care Act 1557 would cause patients to become aggressive. Using an open-ended questionnaire, this study involved the training of 74 staff at a Central California hospital who perform patient registration, in managing potential patient aggression during the new registration process and tested the effectiveness of the training. Results suggest that trainings are successful in helping staff identify pre-violent behaviors, use newly learned de-escalation strategies, and approach patient aggression from an appropriate perspective. Communication skill trainings are useful for teaching staff to identify patient pre-violent behaviors, and improving staff attitudes and approaches toward patient aggression. Hospitals should educate staff about the causes of patient aggression, and communication strategies to de-escalate. Lastly, staff should be encouraged to make external attributions for patient aggression.