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May 9, 2018

Addressing Healthcare Workplace Violence On An Organizational Level

Written by: Compliance blogger


Last month was Workplace Violence Awareness Month. The Center for Disease Control and Prevention (CDC) National Institute for Occupational Safety and Health (NIOSH) defines workplace violence as “an action (verbal, written, or physical aggression) which is intended to control or cause, or is capable of causing, death or serious bodily injury to oneself or others, or damage to property. Workplace violence includes abusive behavior toward authority, intimidating or harassing behavior, and threats.” Though this year’s month of awareness has passed, it is important that conversations about workplace violence continue alongside efforts to reduce it.

Taking the healthcare industry as one example, issues of workplace violence are extremely important to address because the aftermath includes both physical injury and psychological components related to how secure healthcare workers feel when they return to work. This is why it is increasingly important, particularly in industries such as healthcare where workplace violence is so prevalent, that organizations continue to work towards reducing and addressing workplace violence.

How Common is Healthcare Workplace Violence?

In the decade between 2002 and 2013, the United States Department of Labor and the Occupational Safety and Health Administration (OSHA) found that occurrences of serious workplace violence, which required time off work for the injured worker to recover, were four times more common in healthcare than in private industries. Among healthcare workers, psychiatric aides experienced the highest rate of violent workplace injury with 590 reported injuries per every 10,000 full-time employees. Nursing assistants made up the next highest at-risk group with 55 injuries among every 10,000 full-time employees. For comparison, all of the reported incidents in the private industry combined equaled only 4.2 injuries per 10,000 full-time employees.

Patients were the cause of a staggering 80% of reported serious violent incidents in healthcare workplaces, with “other clients or customers” causing an additional 12% of violent workplace events. The Joint Commission has publishing a number of Sentinel Event Alerts designed to help healthcare organizations recognize workplace violence and better prepare their staff to handle violent incidents. One such publication is their recent Sentinel Event Alert Issue 59, which discussed the prevalence of physical and verbal abuse experienced by healthcare workers alongside suggestions for organizations to address such abuse.

What Can Healthcare Organizations Do to Mitigate Workplace Violence?

The Joint Commission argues that “each episode of violence or credible threat to health care workers warrants notification to leadership, to internal security and, as needed, to law enforcement, as well as the creation of an incident report.” Unfortunately, reporting a violent incident at work is voluntary, so it is possible that many healthcare workers who experience violence in their workplace ultimately do not report it. The Joint Commission also notes that tracking healthcare workplace violence is difficult because there are often many different systems that healthcare workers might use to report an injury obtained during work depending on the type of injury, where they were when they were injured, and other characteristics. Therefore, when an organization is examining data about on-site workplace violence, it should take into account the fact that there may be multiple locations where reports of workplace violence have been submitted.

Together, the U.S. Department of Labor and OSHA suggest that an effective program to prevent and reduce workplace violence should utilize:

  • Managerial staff commitment and worker participation
  • Worksite analysis and the identification of hazards
  • Hazard prevention and control
  • Health and safety training
  • Documentation and periodic program evaluation

Some organizations also suggest that specific actions should be taken by healthcare organizations to both mitigate workplace violence and address its occurrences. For example, actions suggested by The Joint Commission include:

  • Clearly define workplace violence and put systems into place across the organization that enable staff members to report instances of workplace violence, including both physical and verbal abuse.
  • Track and analyze all reports of workplace violence, including verbal abuse and attempted assaults where no harm occurred.
  • Follow up appropriately on all incidences of workplace violence while providing support to victims, witnesses, and others affected by each incident.
  • Review each case of workplace violence to determine contributing factors and develop initiatives to reduce incidents of workplace violence.
  • Train staff members in conflict de-escalation, self-defense, and emergency code response.
  • Continuously evaluate workplace violence reduction initiatives by surveying employees to determine the effectiveness of current violence reduction strategies.
  • Stay informed about new initiatives to limit and address workplace violence.

Additional Resources


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