Workplace Violence Prevention: We Need to Better Protect our Healthcare Workforce

Helping the healthcare workforce stay safe on the job

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Workplace violence prevention and safety in the workplace is a critical issue in virtually every industry and sector. This is especially true in healthcare where personnel are at the highest risk of experiencing violence at work. According to the American College of Emergency Physicians (ACEP), 71% of emergency medicine physicians have witnessed an assault at work while 47% of have been the victim of a physical assault. Of the physicians who were assaulted, virtually all (97%) reported that the attacker was a patient. Eighty-three percent of physicians reported that a patient threatened to return to the facility to harm them.

Healthcare Settings Often Include a Unique Combination of Risk Factors

The National Institute for Occupational Safety and Health (NIOSH) lists several risk factors unique to healthcare settings. These include:

  • Working with volatile people, possibly under the influence of drugs or alcohol, or people with certain mental illness diagnoses.
  • Close quarters during transport in high-pressure situations.
  • Overcrowded and uncomfortable waiting rooms.
  • Understaffed offices and long wait times for services.
  • Unrestricted access to the premise.

Operational Conditions Also Enhance the Risk of Violence

Additional factors complicate a typical healthcare facility’s threat environment. Just think of the setting. Many emergency rooms, for example, are open 24/7 – including at night in major urban centers where perpetrators of domestic violence, gang violence, and other criminal activity can follow their victims into healthcare locations and continue to wreak havoc.

Emotions run high in these locations as patients and families deal with factors such as pain, stress, lack of privacy and uncertainty. Security personnel may or may not be sufficiently staffed, trained and alert. Furthermore, security technologies may not be particularly robust, well-maintained or even in working order. This includes access controls for entrances and exits, surveillance cameras and even lighting in high-risk areas, such as emergency room parking lots.

Every Healthcare Facility Should Have a Workplace Violence Prevention Program

Some healthcare administrators point to their facility’s emergency management plan. “We’re as prepared as we can be,” they say. “Especially since workplace violence is merely one of many other risks we must address, such as fires, natural disasters, chemical spills and suicides. Our plan is designed to help us plan and minimize the consequences of all of these.”

Fair argument, right? Not necessarily. Workplace violence prevention is a highly specialized area. A generic emergency management plan without a detailed annex dedicated to workplace violence prevention does not represent sufficient protection against this threat.

What a Healthcare Facility’s Workplace Violence Prevention Program Should Include

Effective workplace violence risk management strategies differ for each facility depending on the location, the population served, the staffing requirements and other factors. The most successful programs include the following:

  • Baseline threat assessment capabilities.
  • Establishment of a cross-functional, multidisciplinary Threat Management Team (TMT) or teams, either in-house or external.
  • Core operational policies and practices related to compliance, privacy, reporting and incident tracking.
  • Background checks upon hiring and regularly thereafter.
  • Physical security measures, such as hiring security guards, hardening access points and installing surveillance cameras.
  • A plan to respond and recover if a violent act occurs.
  • Training – role-based, ongoing and annual.
  • Defined roles and contributions expected from key participants, such as experts in behavioral threat assessment and management, forensic psychology, investigations, security risk management and law enforcement.
  • Partnership with local law enforcement to ensure they are familiar with critical information, from site layout to key points of contact

Nationwide, our healthcare workers help us lead safe, productive, healthy lives. At the very least, it’s imperative that we help ensure that their work environment does the same for them.

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