The most effective method for predicting violent behavior within 24 hours.
The Brøset Violence Checklist (BVC) is a risk assessment tool that can predict aggression in a 24 hour perpective. It has proven its value scientifically and practically. The BVC is in use in more than 40 countries and in a variety of settings in health care and beyond in order to improve workplace safety and to save costs.
Check the free Brøset Violence Checklist E-learning.
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The BVC assists in the prediction of imminent violent behaviour with only 6 questions.
The Brøset Violence Checklist is a 6-item checklist which assists in the prediction of imminent violent behaviour (24 hrs perspective). The BVC found its origin in Mental Health care and can be used by all staff working with patients or clients. When used appropriately it helps to predict and prevent unwanted behaviour among in a variety of setting, also outside Mental Health care. The checklist is well underpinned by research including several RCT’s in a number of countries and settings. As a result it improves the therapeutic climate among fellow patients and staff and even saves lives and therefor cuts down heavily on safety costs. The BVC can also work well in other organisations in other sectors than healthcare that deal with aggression and other unwanted behaviour as well as reducing use of restrictive measures such as restraint and seclusion - in line with political ambitions on national and international level.
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BVC Module within the Re-Act Software
- Installation software included
- Various complex analyses on multi-company levels (Patient, unit, organizational)
- Possibility to expand with multiple modules
- Outstanding user experience
BVC integration in third party software
- Third party is responsible for integration
- Look and feel after own preference
- Pay per use, BVC only
- Assistance with integration in third party software
How does the BVC method work?
A brief explenation, how to use the BVC
1. Observe the client.
When using the BVC professionals are observing 6 items/behaviours in their usual interaction with clients/patients. With the BVC the observations are systematized and documented using an evidence based tool for violence risk assessment.
The BVC uses 6 different items that reflect that mood setting.
Items which indicates the risk of violence.
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ConfusedAppears obviously confused and disoriented. May be unaware of time, place or person.
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IrritableEasily annoyed or angered. Unable to tolerate the presence of others.
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BoisterousBehaviour is overtly 'loud' or noisy. For example slams doors, shouts out when talking etc.
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Physical threatsWhere there is a definite intent to physically threaten another person. For example talking of an aggressive stance; the grabbing of another persons clothing; the raising of an arm, leg, making of a fist or modelling of head-butt directed at another.
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Verbal threatsA verbal outburst which is more than just a raised voice; and where there is a definite intent to intimidate or threaten another person. For exampe verbal attcks, abuse, name calling, verbally neutra comments uttered in a snarling aggressive manner.
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Attacking objectsAn attack directed at an object and not an individual. For example the indiscriminate throwing of an object; banging or slamming windows; kicking, banging or head-butting an object; or the smashing of furniture.
2. Score the client.
The BVC is quick and easy-to-use, one needs to score on 6 items only, which can be done within a minute. Absence of behavior gives a score of 0. Presence of behavior gives a score of 1.
For example, if a well know client normally is confused (has been so far a long time) this will give a score of 0. If an increase in confusion is observed this gives a score of 1.
Score on absence or presence of each behavior.
- 1. Is the patient confused?1
- 2. Is the patient irritable?1
- 3. Is the patient behaving boisterous?0
- 4. Does the patient threat verbally?1
- 5. Is the patient physical threatening?0
- 6. Does the patient attack objects?0
- The sum of the total score.3
- 0 The risk of violence is small.
- 1-2 The risk of violence is moderate. Preventive measures should be taken.
- 3-6 The risk of violence is high. Preventative measures should be taken and plans about how to manage an attack made.
3. Analyse and adjust
The total sum of scores indicates that the risk of violence is either small (0), moderate (1-2) preventive measures should be taken, or high (>2) preventive measures should be taken and plans about how to manage an attack should be made. After a period of time policies can be adjusted on
different organisational levels in order to minimize the risk of violence. This will result in a friendly work floor, less aggression and even saves lives.
Publications
view all- BVC 10 march 2022 GGZ Standards - Dutch - GGZ Standaarden
- BVC Re-Act Software 17 december 2020 Development, implementation and evaluation of a process to recognise and reduce aggression and violence in an Australian emergency department
- BVC Re-Act Software 2 november 2020 Brøset Violence Checklist (BVC) versus Dynamic Appraisal of Situational Aggression-Inpatient Version (DASA-IV): their sensitivity, specificity and accuracy as a predictor of violence in 24 hours among schizophrenia patients
For the BVC method Frenzs has developed an app.
The BVC Web app is free to use for individual users.
Customers who use BVC wisely
Meet one of the authors of the BVC Method.
Dr. Almvik
Dr. Philos Roger Almvik, is a senior researcher at the Bröset Centre for Research and Education in Forensic Psychiatry, St. Olavs University Hospital in Trondheim, Norway. He also holds a post as associate professor at Norwegian University of Science and Technology, Institute of Mental Health. Dr. Almvik has a background as a Mental Health Nurse and his research interests are mainly in (violence) risk assessment in various settings in clinical psychiatry. Dr. Almvik has published and presented widely internationally. He is also a co-founder, executive board member and former chair of the EViPRG – European Violence in Clinical Psychiatry Research Group as well as former board of directors member for International Association of Forensic Mental Health Services (IAFMHS).
Frequently Asked Questions
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Do we need to train our staff?
Training staff in handling violent incidents within the organization is always advisable. The Brøset Violence Checklist stands out for its simplicity, making it highly accessible and efficient to implement within the organization and its workflow. While training is not mandatory, we have developed an E-learning module that covers the fundamentals of the methodology, which is available for free. Check the Brøset Violence Checklist E-learning.
Additionally, we collaborate with a global leader in staff training. Feel free to reach out to us for inquiries about staff training, and we'll offer you a suitable solution.
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Is BVC for acute settings only ?
No, BVC was originally developed at a forensic/secure hospital but several studies show that BVC is a valid risk assessment tool in a variety of settings. In fact, it seems like BVC works very well in all kind of settings (also outside institutional care) where introduced. Please see references on the webpage and/or the references in the e-learning module.
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The basic form of the BVC is for 3 shifts, can the form be altered for e.g. 2 shifts ?
Yes, you are free to adjust the form to your/your organisations needs regarding shifts.
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Can I add and/or remove items in the BVC ?
No, not without written consent from the authors. It is most important the BVC remains with its original 6 items. However, in certain settings it might be valuable to add a few items – please contact Frensz or the author.
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When (during a shift) is the best time to score on the BVC ?
There is no straight forward reply to that. The BVC is so easy to learn and remember that “scoring” is an ongoing process. However, some/most do the formal scoring on the sheet or electronically related to ward/shift handover etc.
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Is it necessary to score all the patients/clients/service users all the time ?
No, not at all. This is an issue for the whole treatment group to decide based on general risk assessment factors. It is important that staff don’t do “paperwork” they feel/experience is of no use; i.e. scoring patients etc zero day in and day out.
Such including criteria could be a known history of violence, active psychosis, certain personality disorders etc.
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Multiple studies have found that (severe) aggressive incidents, and/or the use of coercive measures go down when a ward team starts to use the BVC on a daily basis. What are the potential explanations for these reductions?
Risk assessment and management goes hand in hand. Risk assessment is all about preventing violence and agresssive behaviour, hence a powerful risk assessment tool like BVC will reduce both aggressive behaviour and the need for coercive measures like restraint and seclusion.
Still have questions?
Roel Ruiken
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