Impact of the Built Environment on Staff Security in Mental and Behavioral Health EDs

Mardelle Shepley Professor, Cornell University

This portion of the panel presentation will describe a recent research project on the importance and effectiveness of environment qualities and features in mental and behavioral (MBH) settings and their relationship to staff safety in an emergency department (ED).

A literature review provides limited information regarding design and research on MBH EDs. Two areas have been briefly addressed, the entrance and assessment rooms.. Huddy (2014) discusses the location and number of entrances in relationship to staff safety and Hunt and Sine (2015) describe the role of duress alarms in assessment rooms.

To expand our knowledge of the design of MBH facilities, the purpose of our study was four-fold: to develop and test a tool for the evaluation of MBH facilities, to evaluate the importance and effectiveness of specific environmental qualities and features; to generate design guidelines for MBH facilities, and to make recommendations for future research. A draft version of a tool intended to measure the importance and effectiveness of environmental qualities and features in MBH facilities was developed using a multi-methods approach. This survey, the Psychiatric Staff Environmental Design (PSED) tool, was distributed to psychiatric nursing organization members (N = 134). Among the findings was the importance of staff safety features, which was considered to be a priority over furniture, staff respite, damage resistant furniture, electrical light quality and comfortable furniture. The overall results of this study will be summarizd.