High rates of violent acts against heath care workers pose a serious risk to the safety and wellbeing of the medical and support professionals on the front lines of patient care. Studies show that health care workers are five times more likely to be victims of workplace violence than the public.
Such violence includes threats, verbal abuse, physical assault, and even homicide and has a negative impact on employees’ mental health. Therefore, health care employers should implement policies and procedures to keep their employees and patients safe.
Effective workplace violence prevention programs should have clear goals and objectives and be suitable for the size and complexity of the organization. The program must be adaptable to specific situations, facilities, and units and regularly assessed to respond to organizational changes.
The key elements of an effective program are management commitment, employee participation, worksite analysis, hazard prevention and control, training, and recordkeeping and program evaluation. As an initial step, health care entities should conduct risk assessments to identify risk factors in specific work scenarios and develop strategies for reducing them. Such an assessment should include a review of records, procedures and operations for different jobs, employee surveys, and workplace security issues. The results of the review should then be used to identify the types of prevention and control measures needed to reduce or eliminate the possibility of a workplace violence incident occurring and assist in the identification or development of appropriate training. OSHA has checklist that you can adapt.
There are certain risk factors that organizations should recognize and address:
- Working directly with people who have a history of violence, abuse drugs or alcohol, gang members, and relatives of patients or clients;
- Transporting patients and clients;
- Working alone/being understaffed;
- Poor environmental design that may block employees’ vision or interfere with their escape;
- Poor lighting;
- No means of emergency communication;
- Prevalence of firearms, knives and other weapons;
- Working in neighborhoods with high crime rates;
- Inadequate security and mental health personnel;
- Long waits in uncomfortable waiting rooms; and
- Unrestricted movement of visitors.
Risk factors can be minimized by selecting and implementing effective controls to eliminate or reduce hazards. Such controls may be physical (e.g., alarms, barriers, lighting); security measures (e.g., logs, escorts, buddy system); entry procedures; and having trained, qualified staff present during high risk times (e.g., transfers, meals).
Strong post-incident procedures can minimize the impact of a violent incident. These include providing first aid and emergency care for the injured, having follow up programs for impacted employees (e.g., trauma crisis counseling), and conducting a thorough investigation and root cause analysis of each incident and near miss.
Once an organization adopts sound policies and procedures, training should be conducted for all workers, contract workers, supervisors, and managers to ensure they have an adequate understanding of the workplace violence prevention program and the organization’s commitment to a culture that does not tolerate violence.
Qualified health care and employment counsel can guide health care organizations in developing workplace violence programs that fit their operations.