Trained and Ready

Dealing with workplace violence in the healthcare environment means having the policies, procedures and training in place to respond quickly and effectively

Sifting through the reams of data available on workplace violence, it becomes clear that the issue has been on the radar of healthcare executives for more than a decade.

Back in 1998, the Occupational Safety and Health Administration (OSHA) reported that “more assaults occur in the healthcare and social services industries than in any other.” And while the statistics say healthcare workers are no longer the top target for workplace violence, it is clear they remain on the front lines. “It’s prevalent and it’s escalating,” says Anthony Potter, senior director of public safety administration for Novant Health, which operates 13 hospitals in Virginia and the Carolinas.

What are the major contributing factors to violence in the healthcare environment? Among the many factors, the number-one issue, according to Potter, is the economy. “We are dealing with a far greater percentage of our population that’s under economic stress, and this is always a trigger for workplace violence and also for domestic violence, which can spring over into the workplace.”

Other contributing factors include long waits in the emergency room, overcrowding of hospitals and the lack of beds and rooms available at any given time, along with intoxicated patients. But luckily for healthcare security executives like Potter, the problem of workplace violence is so universal, so widespread and frankly, so mature, that strategies to deal with it have evolved greatly over the years.

For Potter and Novant Health in particular, the key to curbing workplace violence lies mostly in the hands of the security officers on the front lines on a day-to-day basis.


The Scope of the Problem

The LaborDepartment defines workplace violence as “any threat or act of physical violence, harassment, intimidation, or other threatening disruptive workplace behavior.” The impact of non-fatal instances of workplace violence is significant, with the FBIestimating in 2011that occurrences of workplace violence “cost the American workforce approximately $36 billion per year.” The FBI separates workplace violence into four categories based on victim-perpetrator relationship:

• Crime: when a perpetrator who has no connection to the organization attempts a criminal act, such as a robbery;

• Customer or patient: Most common in the healthcare environment, the act is perpetrated by an a patient or other outsider to an organization;

• Worker on worker; or

• Domestic violence.

According to the 1998 OSHA stats, the average rate of assaults against health workers was more than four times greater than that for the rest of the private sector.

When thinking about workplace violence in the healthcare setting, the obvious circumstance involves the emergency room, for a variety of reasons. Potter points out that the current economic climate has many emergency room visitors treating the unit as their family doctor — thus creating instant problems with wait times and bed/doctor availability.

But to boil it down to its simplest term, a trip to the emergency room is easily one of the highest-stress situations a person can experience. “There’s always stress involved when someone comes to a hospital, because unlike nearly any other place, they don’t want to be here,” Potter says. “As a result, the tension level is high to begin with.”

Several studies indicate that violence often takes place during times of high activity and interaction with patients, such as at meal times, during visiting hours and patient transportation. Assaults may occur when service is denied, when a patient is involuntarily admitted, or when a healthcare worker attempts to set limits on eating, drinking or tobacco or alcohol use.

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