System Dynamics Modeling to Improve Safety and Quality of Agitation Management and Workplace Violence in the Emergency Department
Simulating the complex, interconnected drivers of behavioral health emergency care to identify high-impact, sustainable solutions.
Understanding a Complex System
Behavioral health emergencies are increasing across the United States, placing significant strain on emergency departments (EDs), healthcare workers, patients, and health systems. Despite growing recognition of the challenges associated with emergency behavioral health care, including workplace violence, staff burnout, prolonged ED stays, and the use of restrictive interventions, health systems often lack tools to understand how these interconnected factors influence one another over time. As a result, efforts to improve behavioral emergency care may have unintended consequences or fail to achieve sustainable improvements.
This NIH-funded project uses system dynamics modeling to better understand the complex factors that drive behavioral health emergency care outcomes. System dynamics is a simulation-based approach that examines how interactions among patients, clinicians, operational processes, and healthcare environments create patterns of outcomes over time.
Mapping the Drivers of Crisis Care
The project engages patients, family members, clinicians, hospital leaders, and community stakeholders to identify key drivers of behavioral health crises and map the relationships among the factors that shape outcomes in the ED.
- Staffing
- Patient flow
- Workplace violence
- Staff burnout
- Use of restraints
- Access to mental health resources
- Quality of care
Building & Testing Simulation Models
Using stakeholder-informed models and real-world data, the research team develops and tests simulation models that can evaluate potential interventions before they are implemented in practice, allowing health systems to spot unintended consequences in advance.
- System dynamics modeling
- Stakeholder engagement
- Real-world data
- Pre-implementation testing
From Insight to Impact
These models help health systems identify high-impact strategies for improving patient outcomes, enhancing staff safety and well-being, reducing reliance on restrictive interventions, and creating more equitable and effective behavioral health care systems.
- Improved patient outcomes
- Enhanced staff safety & well-being
- Reduced restrictive interventions
- More equitable care systems
Why This Research Matters
The long-term goal of this research is to provide healthcare leaders and policymakers with evidence-based decision-support tools that can guide investments and interventions at every level of the system.
Patient Level
Improving the experience and outcomes of individuals presenting with behavioral health crises.
Provider Level
Supporting the safety, well-being, and decision-making of frontline clinical teams.
Organizational Level
Helping hospital leaders evaluate strategies and investments before they're put into practice.
System Level
Guiding policy and investment decisions that shape behavioral emergency care nationally.
Stakeholder Engagement
Patients, family members, clinicians, hospital leaders, and community stakeholders are engaged throughout to identify key drivers and inform every model the team builds.
Interested in the System Dynamics project?
We welcome collaborators, clinicians, community partners, and trainees who share our commitment to improving behavioral emergency care.
Get in touch ↗