General Hospital Agitation Management: Leadership Theory and Health Care Team Best Practices Using TeamSTEPPS

Brandon Hamm*, Leopoldo Pozuelo, Rebecca Brendel

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Background: Acute agitation management is an emergency clinical intervention, often presenting acute danger to patients and medical staff. Unlike many other emergency clinical interventions, acute agitation management lacks a substantial evidence base regarding leadership and teamwork best practices. The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) framework is a comprehensive strategy for improving health care outcomes in acute clinical situations. Objective: Practical application of TeamSTEPPS frameworks in team-based acute agitation management in the medical setting. Methods: A literature review was performed from January 1990 to March 2021 for verbal de-escalation in acute agitation management, leadership and teamwork in psychiatry and medicine, and TeamSTEPPS. Results: No literature was found that applied TeamSTEPPS for acute agitation management in the general medical unit context although limited application has been trialed in the inpatient psychiatric context. The verbal de-escalation literature describes applicable content including conflict management approaches, communication strategies, security presence management, modeling therapeutic behavior, and debriefing strategies. Several articles were found regarding a rapid response team model for acute agitation management and describing handoff tools in psychiatric care contexts. Translation of the TeamSTEPPS approach provided many additional approaches for operation of a rapid response team in acute agitation management. Conclusions: The leadership and teamwork best practices in TeamSTEPPS provide a clear and actionable framework for team-based acute agitation management as an emergency clinical intervention.

Original languageEnglish (US)
Pages (from-to)213-224
Number of pages12
JournalJournal of the Academy of Consultation-Liaison Psychiatry
Issue number3
StatePublished - May 1 2022


  • TeamSTEPPS
  • agitation
  • handoffs
  • leadership
  • teamwork
  • verbal de-escalation

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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