Open Forum

We are seeking a policy or guidelines for a patient who verbalizes the intent to harm others. For example, what do we do when patients say they intend to hurt people in a school. We have policies for suicidal patients but do not have a policy for homicidal patients. I don't want to recreate the wheel if someone already has one and will share.

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Barry Owen BSN,MBA,NEA-BC,RN
Vice President and Ambulatory ACNO
Children's Health System Dallas
(214)456-0998
barry.owen@childrens.com
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Hello, Barry:
We use Schmitt-Thompson telephone triage protocols that are imbedded in our Epic EHR.  If you have purchased the content, the pediatric protocol that would be applicable for this is "Aggressive and Destructive Behavior."  Pediatric Telephone Protocols, 17th edition (paperback) is available for purchase on Amazon.

For in-person threats, we follow the Lippincott Procedures - Homicidal Risk Assessment, Ambulatory Care.

In any scenario, we have a Duty to Warn when the patient communicates a serious threat of imminent physical violence. The threat must be directed towards a specific and identifiable third person, group or facility.  Security and/or Law Enforcement are notified as appropriate.

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Michaelene Wolff, BSN, RN, OCN, AMB-BC
Coordinator, Clinical Programs
Chair, Ambulatory Telephone Protocol Committee
University of Colorado Hospital
Aurora CO
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That is very helpful.  Thank You

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Barry Owen BSN, MBA, NEA-BC, RN
Vice President and Ambulatory ACNO
Children's Health System Dallas
(214)456-0998
barry.owen@childrens.com
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Original Message:
Sent: 07-08-2022 10:31
From: Michaelene Wolff
Subject: Policy for homicidal patients.

Hello, Barry:
We use Schmitt-Thompson telephone triage protocols that are imbedded in our Epic EHR.  If you have purchased the content, the pediatric protocol that would be applicable for this is "Aggressive and Destructive Behavior."  Pediatric Telephone Protocols, 17th edition (paperback) is available for purchase on Amazon.

For in-person threats, we follow the Lippincott Procedures - Homicidal Risk Assessment, Ambulatory Care.

In any scenario, we have a Duty to Warn when the patient communicates a serious threat of imminent physical violence. The threat must be directed towards a specific and identifiable third person, group or facility.  Security and/or Law Enforcement are notified as appropriate.

------------------------------
Michaelene Wolff, BSN, RN, OCN, AMB-BC
Coordinator, Clinical Programs
Chair, Ambulatory Telephone Protocol Committee
University of Colorado Hospital
Aurora CO
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