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A rise in workplace violence garners greater focus from national organizations


A rise in workplace violence garners greater focus from national organizations

OSHA, the CDC, and The Joint Commission are placing more focus on workplace violence prevention, and hospitals are paying attention

Workplace violence is having a moment. It's an issue that has always been on the radar of security management, but over the last several months, a number of national organizations have highlighted workplace violence as a top concern for both patient safety and employee safety.

Last month, OSHA released Guideline 3148 aimed at preventing workplace violence in healthcare settings. The updated guidelines focused on management's commitment and employee participation, work site analysis, and hazard prevention and control. (For more on 3148, read the June issue of Briefings on Hospital Safety).

Workplace violence also recently showed up on two top 10 lists.

According to an April report by The Joint Commission, hospitals reported 47 criminal events (rape/assault/homicide) in the past year, making it the eighth most common sentinel event. Workplace violence took the third spot on ECRI's "Top 10 Patient Safety Concerns for Healthcare Organizations in 2015," released in April.

The CDC also released a report in April that reviewed occupation traumatic injuries among healthcare workers from 2012?2014.

Statistics collected from hospitals through the Occupational Health Safety Network (OHSN) showed that healthcare workers suffered traumatic injuries due to workplace violence at a rate of 4.9 incidents per 10,000 worker months.

This kind of attention is making workplace violence a priority, particularly among accrediting organizations, says Karim H. Vellani, CPP, CSC, president of Threat Analysis Group, LLC in Houston.

"It's certainly rising to the top of the heap for everyone because the violent crime rate in hospitals is going up," he says. "Patient-on-staff assaults continues to be the most common type of assaults on hospital campuses."

Vellani's last statement is shockingly true. A 2015 "Healthcare Crime Survey," published by the International Healthcare Security and Safety Foundation (IHSSF), showed that violent crime rates in U.S. hospitals has risen from two incidents per 100 beds to 2.8 incidents per 100 beds between 2012 and 2014. But an overwhelming amount of that violence was categorized as Type 2, or patient-on-staff or visitor-on-staff violence. Seventy-nine percent of aggravated assaults and 90% of assaults were categorized as Type 2, according to the report.

The following is a list of high-risk areas that hospitals can focus on regarding workplace violence prevention:

  • Be aware of clinics: One emerging trend Vellani has seen recently is violence in outpatient clinics. With the Affordable Care Act, patients that were receiving care at the ED are now visiting clinics. A subset of those patients that caused problems in the ED are transferring that to the outpatient setting. "The most challenging thing about this is that historically, we've emphasized hospital security a lot, but not outpatient medical buildings or the physician's office," he says. "That's going to take a considerable amount of effort to assess the security needs of those off-campus facilities and obviously a considerable amount of money to upgrade their security systems or security practices."
  • Getting a seat at the table: Although security officers are often asked to respond to events, hospitals should take a more proactive approach to workplace violence, says Lisa Pryse Terry, CHPA, CPP, president of the healthcare security services division and chief of company police at ODS Security Solutions in Raleigh, North Carolina. That means getting a formal role as part of a workplace violence prevention program. "What I've seen over the past couple years is we're much more of a collaborative member at the table before these situations occur," she says. "We plan our response and plan when we know a certain patient has been admitted or is going to be admitted or coming back."
  • Targeting frequent flyers: Hospitals need to get better at flagging reccurring patients with a violent history. VA hospitals, for example, have a system in place so that if a patient has a violent episode at a hospital in Virginia, that will be noted in the system when he shows up to a facility in Houston.
  • Staff training: Security officers always receive de-escalation training, but it's equally important that clinicians are able to manage a potentially violent situation.

"Everyone that comes in contact with a patient should have some sort of de-escalation and ongoing de-escalation training and certification each year," Terry says.

  • Evidence-based interventions: The next step in workplace violence prevention is narrowing down which interventions work and which ones do not. As a board member of IHSSF, Vellani says the organization has at least three papers planned this year that focus on evidence-based security interventions, and he expects the industry as a whole will begin to make that transition in order to better understand how to most effectively use their resources.

"Is there value in particular measures? Is there deterrence value in having a security officer sitting in the emergency department waiting room? Is de-escalation training reducing the number of injuries or assaults that occur? That's what's lacking in the industry," he says.

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