Violence Prevention at Veterans Medical Center

Over the summer, Center for Prevention Programs and Partnerships’ (CP3’s) Las Vegas Regional Prevention Coordinator and West Region Associate Director visited the North Las Vegas Veterans Affairs (VA) Medical Center to learn about its workplace violence prevention program and discuss opportunities for collaboration. The CP3 team met with Workplace Violence Prevention Program Manager Dr. Meredith Avedon and Deputy Program Manager Felicia Douville, LCSW. 

The North Las Vegas VA Medical Center serves more than 80,000 veterans who reside in the greater Clark County and southern Nevada area. Health officials regularly coordinate with the VA Police Department (VAPD) to foster a safe environment on the campus. Training, mutual respect, and “being on the same page” are vital to creating a healthy climate for patients, staff, and visitors to the hospital or clinics throughout the valley. 

Three key programs exist to address workplace violence prevention at the VA in southern Nevada:

1. The Disruptive Behavior Committee (DBC) is an interdisciplinary team responsible for assessing and managing disruptive behaviors.

2. The Prevention and Management of Disruptive Behavior (PMDB) program teaches safety skills to employees and staff to prevent instances of workplace violence.

3. The Employee Threat Assessment Team (ETAT) is an interdisciplinary team responsible for addressing risk of violence posed by employees.

All three complement each other at the facility. Additionally, a robust reporting system — the Disruptive Behavior Reporting System (DBRS) — is trained to all staff to report incidents of workplace violence, concerns, or threats. 

The Workplace Violence Prevention Manager and Deputy Manager both work to ensure all parties involved understand the value of behavioral threat assessment and management (BTAM) work. They also take a violence risk assessment inventory (VRAI), specifically designed for use in the VA healthcare system for persons of concern. The VRAI analyzes risk and protective factors that may be influencing behaviors. An interdisciplinary body subsequently looks at each VRAI and develops a treatment and management plan based on input obtained during case reviews. Areas of highest need often include housing, primary care, and suicide prevention for the veterans in crisis.

The workplace violence prevention team, along with the VAPD, often collaborate with the Las Vegas Metropolitan Police Department (LVMPD) Threat Assessment Team to ensure adequate care and management when a veteran in crisis is off the medical center campus and in the community. If a veteran is deemed ineligible for services, the local BTAM team is asked to provide assistance. 

Mutual training between VA and LVMPD helps ensure a culture of prevention and that the same language is being spoken between vastly different agencies. Monthly calls, case scenarios, and training empower all parties to properly support veterans. Training, management, and case coordination all support the goal of preventing workplace violence at the facility, as well as preventing targeted violence upon return to the community.