The Behaviour Emergency Response Team (BERT) Call Initiative is a highly acclaimed and person-centered program designed to proactively mitigating the need for Code White calls. The team effectively intervenes to de-escalate behaviours exhibited by older adults who are either experiencing acute delirium and/or associated with dementia. The primary focus of this approach is to cultivate expertise in behaviour support directly at the point of care, catering to the needs of older individuals facing responsive behavioural challenges in both acute and sub-acute healthcare environments.


Awards and Recognition

Choosing Wisely Trailblazer BadgeSince its inception in April 2017, the initiative has achieved numerous milestones and garnered widespread recognition for its exceptional contributions to patient care. Notably, in 2020, the initiative earned international acclaim as the Quality Care Hospital (QCH) was bestowed with a prestigious award in acknowledgment of its accomplishments.

A remarkable feat came in the form of the Trailblazer Award, conferred by the NICHE (Nurses Improving Care for Healthcare System Elders) program and the American Board in Internal Medicine (ABIM) Foundation. This award underlines QCH's distinguished achievement in advancing the quality of care for patients 65 years and older, by prioritizing their safety and enhancing the coordination of care. This recognition symbolizes QCH's pioneering role in reshaping the landscape of geriatric healthcare.

The person-centered approach in geriatric care is at the heart of the BERT Call Initiative which has resonated deeply and led to the adoption of this transformative approach by numerous hospitals across Ontario. The ripple effect of QCH's success has paved the way for the widespread implementation of this initiative, magnifying its impact on the care of the older adults across the province.


Model of Care

The purpose of the BERT code is to respond urgently to requests from point of care providers when a patient over the age of 65 develop responsive behaviours while in hospital either associated with delirium and/or dementia. The team that urgently responds to the escalating behaviour is specialized in behaviour support and geriatrics. Patient and staff safety must be the first consideration which is why it is not made to be an urgent response. The BERT Call Initiative follows a Pre-Code White model. The team collaborates with protective services to de-escalate without physical redirection. The BERT call concept is designed on a non-pharmaceutical and non-physical redirection approach. The team provides a review of patient’s chart and behaviour and focuses on identifying the “meaning behind the behaviour.”


The three objectives of a BERT Call are:

  • Avoid a Code White situation by utilizing a person-centered approach.
  • Capacity building through coaching at the bedside through improved health care providers knowledge on personalizing the care approach with geriatric patients with delirium and/or living with dementia who are experiencing escalating behaviours.
  • Enhance the care of the older person who experiences responsive behaviours in acute care. Utilizing a post-BERT Call debriefing is a significant contributor in enhancing patient, family and staff satisfaction.

Improving patient outcomes and enhancing safety of our staff and patients are our priority drivers for the BERT Call Initiative at QCH.


How it Works

When the BERT Code is deemed to be necessary, the point-of-care provider will contact the QCH’s Call Centre to activate the BERT Call. The QCH’s Call Centre will then page BERT members.


Where it is Available

  • BERT Call Acute Care Nursing Team on-site at QCH: Across all inpatient units and our Emergency Department.
  • BERT Call Sub-Acute Care Interdisciplinary Team at our off-site QCH location: Across both QCH’s units at our Park Place location

If you would like to obtain further information on the QCH’s BERT Call Initiative, please contact Melissa Laroche, Advanced Practice Nurse in Geriatrics and BERT Call Initiative lead, at