Transforming Spaces: Interventions in Furniture Layouts to Reduce Patient Violence on a Psychiatry Unit Using a Quality Improvement Approach at University Medical Center
Location
Center for Advanced Learning and Simulation (CALS)
Publication Date
April 2025
Start Date
17-4-2025 8:00 AM
Description
Purpose: Violent behavior is more prevalent among individuals with mental illness than in the general population, with the highest rates observed in acute care settings and involuntarily committed patients (Choe et al., 2013, Varshney et al., 2015). While current research focuses on patient characteristics and staff de-escalation training to reduce aggressive behavior in acute settings, fewer studies examine the role of architectural design or positive environmental modifications to mitigate aggression (Ulrich et al., 2018). This quality improvement (QI) project examines the prevalence of violence in inpatient psychosis units at University Medical Center before and after implementing environmental changes as recommended by a previous QI project that identified key triggers of patient violence (Georgis et al., 2021). Methods: Prevalence of violence was assessed using incident reports from two inpatient psychosis units before (Q4 2024) and after (Q1 2025) environmental modifications. For one unit, furniture was rearranged to separate dining and entertainment areas to reduce social density, and additional recreational activities were introduced. A second psychosis unit that did not undergo these changes served as a control. Descriptive statistics and odds ratio were calculated to compare odds of violence on one unit compared to the other. Results/Anticipated Results: We hypothesize that the prevalence of violence would be lower on the psychosis unit with implemented changes. Discussion: This QI project builds on a previous QI project that identified prominent causes of aggression and suggested evidence-based, cost-efficient changes to reduce aggression. If our hypothesis is correct, findings would demonstrate a reduction of violent incidents on the modified unit. Future studies should explore potential confounding factors such as variations in diagnosis, pharmacological regimens, patient to staff ratios, and length of admission.
Recommended Citation
Pham, Thien-Huong Michelle MD, PhD; Nguyen, Hoang MD, MPH; Hou, Xing Zhu MD; Capone, Erin MD; and Conrad, Erich MD, "Transforming Spaces: Interventions in Furniture Layouts to Reduce Patient Violence on a Psychiatry Unit Using a Quality Improvement Approach at University Medical Center" (2025). Dept. of Psychiatry Research Symposium. 8.
https://digitalscholar.lsuhsc.edu/psych_rd/2025/presentations/8
Transforming Spaces: Interventions in Furniture Layouts to Reduce Patient Violence on a Psychiatry Unit Using a Quality Improvement Approach at University Medical Center
Center for Advanced Learning and Simulation (CALS)
Purpose: Violent behavior is more prevalent among individuals with mental illness than in the general population, with the highest rates observed in acute care settings and involuntarily committed patients (Choe et al., 2013, Varshney et al., 2015). While current research focuses on patient characteristics and staff de-escalation training to reduce aggressive behavior in acute settings, fewer studies examine the role of architectural design or positive environmental modifications to mitigate aggression (Ulrich et al., 2018). This quality improvement (QI) project examines the prevalence of violence in inpatient psychosis units at University Medical Center before and after implementing environmental changes as recommended by a previous QI project that identified key triggers of patient violence (Georgis et al., 2021). Methods: Prevalence of violence was assessed using incident reports from two inpatient psychosis units before (Q4 2024) and after (Q1 2025) environmental modifications. For one unit, furniture was rearranged to separate dining and entertainment areas to reduce social density, and additional recreational activities were introduced. A second psychosis unit that did not undergo these changes served as a control. Descriptive statistics and odds ratio were calculated to compare odds of violence on one unit compared to the other. Results/Anticipated Results: We hypothesize that the prevalence of violence would be lower on the psychosis unit with implemented changes. Discussion: This QI project builds on a previous QI project that identified prominent causes of aggression and suggested evidence-based, cost-efficient changes to reduce aggression. If our hypothesis is correct, findings would demonstrate a reduction of violent incidents on the modified unit. Future studies should explore potential confounding factors such as variations in diagnosis, pharmacological regimens, patient to staff ratios, and length of admission.
Comments
People's Choice Presentation