UCHealth University of Colorado Hospital – Telephone Verbal Violence De-escalation Scripting

UCHealth surveyed over 300 nurses within the ambulatory care setting space (ambulatory nurses, schedulers, triage nurses, nurse navigators and techs) regarding the prevalence of telephone verbal violence and its perception and effects by staff. The results of the survey concluded that greater than 70 percent of nurses surveyed stated they had experienced at least one to four verbally violent calls per week and over 10 percent reported receiving more than 15 verbally violent calls weekly. The survey revealed a lack of resources and guidance for staff experiencing telephone verbal violence. Of the staff who participated in the survey, effects of the verbally abusive encounter included a negative impact on staff wellbeing and organizational productivity, as well as staff being emotionally and mentally impacted for hours after the abusive incident.

As a result of the survey results, UCHealth created a telephone verbal violence scripting tool and de-escalation algorithm to teach staff to de-escalate the aggressor’s language and behaviors. The scripting tool included disconnecting from the call if the de-escalation efforts were unsuccessful, without placing the staff at professional risk.

Early successes include the following:

• Approximately 900 ambulatory care staff members completed education on how to manage difficult calls.
• Staff were empowered to manage the difficult call on their own, without transferring to a leader or other colleague, thus reducing the number of staff exposed to verbal violence.
• Education efforts demonstrated an 11 percent improvement in staff confidence to manage difficult calls.
• Staff reported a 10 percent reduction of emotional impact post education efforts.
• Thirty-three percent of calls are now de-escalated with use of the scripting tool and de-escalation algorithm.
• Twenty-three percent of difficult calls were disconnected by staff.
• Forty-four percent of difficult calls were prematurely terminated by the caller.
• The perception of staff regarding leadership support increased seven percent.

To learn more about this program, please contact Cara Spencer, PhD, RN, FNP-BC, at [email protected].

Additional Information:

Spencer, C., Musenero, R., & Fouse, J. (2022). Prevalence and Determinants of Violence in Ambulatory Care via the Telephone, American Academy of Ambulatory Care Nursing View Point, 44(2), 3-7.