A Refreshed Behavioral Health Response Model: Behind the Scenes with Debrea Griffith and Jim Maurer
Over the last few years, Lurie Children’s is one of many institutions that’s experienced a noticeable increase in behavioral health needs dependent upon inpatient services. As psychology and behavioral health experts have pointed out, the pandemic exasperated an already overwhelming adolescent mental health crisis, and the consequential spike put strain on existing systems.
“As the numbers continued to increase, our inpatient psychiatry unit reached capacity and behavioral health patients were admitted to other inpatient care areas throughout the hospital,” said Debrea Griffith, RN, Director of General Medicine. “This brought an entirely different challenge in how we provide care.”
Griffith notes that as more and more patients presented as aggressive, leadership had to begin rethinking its current approach to emergency behavioral health situations and if there was a smarter way to move forward. “We began to brainstorm what we could do to support our staff and make sure they could comfortably provide care to a patient population they might not be used to seeing,” said Griffith.
In an effort to prioritize safety for everyone involved as well as high-quality, nuanced care for these aggressive patient situations, the Behavioral Response Team (BRT) was established. In addition to creating more touchpoints for behavioral health patient updates (i.e., rounding), the BRT also activated a real-time response effort called the BRT ‘STAT’ with the goal of decreasing employee and patient harm. Behind the STAT is a thoughtful strategy that includes clear response criteria, timelines, de-escalation tactics and language, equipment and resources for bedside, and a trained team of representatives from across departments. This response team has representation from patient safety, nurse and physician leaders from the unit, psychiatry/psychology, security, family services and a designated BRT team lead who all have clearly outlined responsibilities for when a STAT (aggressive patient behavior) is called.
In planning for the BRT’s launch, the decision for who would lead day-to-day operations was an intentional one. The Behavioral Response Team Coordinator role has deep involvement and oversight of a group of BRT staff leads and is a critical part of communication, collaboration, and education across the hospital. Since Jim Maurer, RN – a Lurie Children’s nurse with nearly two decades of experience – has stepped into the new role, the team has raved over the natural leadership, passion, and reassurance he’s instilled in this new initiative.
“He truly took this and owned it,” Griffith said. “The genuineness and passion that he brings to the role, along with true care, concern, and fearless approach, has helped make the BRT so successful. People feel so supported by him, and his unique background made him the perfect unbiased advocate for both patients and inpatient staff.”
Below Jim shares his first-hand experience in a role that’s a combination of his passions realized and why this work matters.
How long have you worked at Lurie Children’s and in what departments?
I have worked at Lurie Children’s Hospital for 17 years. I spent my initial six years as a Milieu Therapist on the Inpatient Psychiatry Unit. Then after becoming an RN, I worked the next 11 years on the Resource Team, which is a team of nurses that are trained to provide care across many inpatient units in the hospital. I lived in Seattle for several years and during that time, worked in the PICU at a pediatric academic medical center there, as well. Several months ago, I transitioned into my current role as the Behavioral Response Team Coordinator.
What drew you to a career in nursing?
I have always been drawn to patient care and nursing was the right fit because it is the perfect blend of compassion, problem solving, teamwork, and dedication. A nurse is someone who will be there for the patient, every day. You don’t back down. You don’t make excuses. You advocate. You comfort. And you do this because the patient deserves it.
How would you describe your role on the BRT to a person who was unfamiliar?
The Behavioral Response Team at Lurie Children’s is a group of staff specially trained in behavioral de-escalation. It is our role to help support bedside staff in caring for patients who present with challenging behaviors in the healthcare setting. We utilize a team-based approach to help staff mitigate behavioral emergencies, with a focus on minimizing staff and patient injuries and maximizing positive patient outcomes.
What does a typical day as the BRT Coordinator look like?
Most days start with the BRT lead staff member and I reviewing charts of the patients that are being followed by our team. After prioritizing patient and staff needs, we communicate with the nurse and other clinicians providing care to those patients. While the BRT lead staff member rounds on patients, I attend Psychiatry and Behavioral Health consultation team rounds. From there, each day generally consists of a blend of meetings with unit leaders, connecting with clinical providers, participating in staff education, responding to BRT STAT calls, supporting the Inpatient Psychiatry Unit, data collection, and lots of coffee!
How did you know you wanted to pursue this role?
I knew that becoming the coordinator of the Behavioral Response Team was a role that I could not pass up because it was one of those rare opportunities in life where a career and passion come together. Work is no longer work. You get to do what you love, and in turn, you love what you do. I am a big believer that passion keeps you engaged in the workplace.
What is fulfilling or motivating for you being part of the BRT?
Every morning I reflect on the significance of the work that the BRT brings to staff and patients throughout the hospital. Having the platform to help others is one of the most rewarding parts of being on the BRT. I am fueled by my opportunities each day to collaborate with a variety of proficient colleagues that motivate and challenge me to be the best version of myself.
What’s something you wish more people understood about behavioral health patient care?
I think that the biggest thing to remember when working with a behaviorally challenging patient is that respect and dignity should always be your first line of intervention.
Anything else you would like to share?
A huge ‘THANK YOU’ to the best team of behavioral responders that a person could dream up. The staff on the BRT inspire me each day through their commitment, expertise, and willingness to take on ever-changing challenges. Thank you for making it your mission to improve the quality of care that children receive at Lurie Children’s.