SHM Converge Scientific Abstract ePoster Gallery-Behavior M and M: A Structured Debriefing on Challenging Patient Encounters

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This document describes “Behavior M&M,” a wellness-focused initiative created to help hospitalists process challenging patient encounters. The program addresses situations that often leave clinicians feeling helpless, frustrated, or emotionally drained, especially when problems involve system barriers, mismatched patient-provider goals, or workplace violence. A survey at Johns Hopkins Hospital found that 39% of hospitalists said caring for patients with behavioral needs affected their moral well-being “tremendously” or “a lot.”<br /><br />Behavior M&M is organized as quarterly one-hour meetings. During each session, a faculty member presents a difficult case, with support from a faculty development director if needed. The format includes a case overview, identification of the main challenges, group discussion, and lessons learned. Example cases included a violent patient with COVID-19, a patient demanding unnecessary IV opioids and benzodiazepines, and a patient refusing most care such as dialysis and lab work.<br /><br />The goals of the program are to create a formal debriefing process after difficult encounters, offer emotional support and practical tools, and normalize the reality that challenging patient interactions are part of clinical work. Common themes raised in discussion include administrative discharge, behavioral partnerships, establishing common goals, setting limits while still meeting patient needs, addressing splitting, and ensuring consultant support.<br /><br />Presenters reported that the experience was therapeutic and helpful. They learned to seek help sooner, set clearer limits, and approach similar situations with more confidence. The authors conclude that formal debriefing through Behavior M&M may reduce the burden of challenging encounters and serve as a valuable addition to clinician wellness programs.

Asset Subtitle

Ashwini Niranjan-Azadi

Meta Tag

Author List Ashwini Niranjan-Azadi, Carrie Herzke

Category Innovations

Concept Behavior MM

Concept Moral Distress

Concept Wellness Intervention

Concept Patient Encounter

Concept Case Presentation

Distinguished Non-Finalist

Presenter Organization Johns Hopkins Medicine

Presenting Author Ashwini Niranjan-Azadi

Track Communication

Keywords

Behavior M&M

hospitalist wellness

challenging patient encounters

moral distress

formal debriefing

workplace violence

patient-provider conflict

clinician support

behavioral health

emotional burnout

Behavior MM

Moral Distress

Wellness Intervention

Patient Encounter

Case Presentation