Workplace Violence Prevention: Hospitals

Hospitals increasingly are raising awareness of workplace violence and implementing prevention programs. What kind of program have you developed to prevent violence in your building? Check out what hospitals are trying. It might give you a few ideas for your building’s program.

Assess for Risk
Hospitals rank high among the most dangerous workplaces. According to the Emergency Nurses Association (ENA), 35-80% of all hospital staff have suffered a physical assault at least once during their careers. A crime and safety survey of 212 hospitals by the International Association for Healthcare Security and Safety counted 660 aggravated assaults and 2,720 simple assaults during 2009.

Observers say hospital violence is worse than the statistics suggest because many incidents go unreported. Nurses, the most frequent victims, tend to think violence is just part of the job. They are less likely to report an incident because they feel nothing can be done about it.

“Raising awareness that this is a problem that can be fixed is the first step,” says JoAnn Lazarus, president elect of the ENA. “You have to find a champion. Often that is the director of the emergency department, which is where many incidents of violence occur. This individual can help to set up a prevention committee with representatives from each department.”

The next step is to conduct an assessment, continues Lazarus. How safe is the hospital? Do you have secured entrances and video cameras? Are there policies and procedures outlining security interventions?

The ENA has created a 50-question assessment tool for hospital emergency departments. Designed for emergency departments, many of the questions could apply to other building types. To read it, go to www.ena.org and use the IENR menu to select Workplace Violence Toolkit.

“After assessing the environment, do a gap analysis of what you’ve found,” Lazarus continues. “Compared to where the assessment says you are, where do you want to be? What do you have to do to get there?”

Since 1995, Mike Fickes has contributed over 200 security articles to publications covering hotel, industrial, office, retail, critical infrastructure, and education. His interests include security management, policies, strategies, and technologies.

1. Commitment: The organizational motivation to prevent violence comes from committed, active senior leadership. “You have to make violence prevention part of the organizational culture,” says Ken Bukowski, vice president, healthcare, with AlliedBarton. “You can’t just put a program in place and forget it. You have to reinforce it constantly.”
2. Liaison: Establish a liaison with the police. “In hospitals where we work, our point person constantly communicates with law enforcement,” says Bukowski. “The police can help with drills and training, and by learning your facility, they will be able to respond better and faster.”
3. Policy: Develop a policy with clear written definitions of violent workplace behaviors along with clear consequences for making verbal and nonverbal threats or engaging in physical violence. Communicate the policy to all.
4. Report: Bukowski recommends educating employees about the signs of workplace violence. A raised voice, name-calling, or an outright threat are signs that should be reported. Further training in what are called de-escalation skills can help employees avoid confrontations and ease tense situations.
5. Reprisal Free: Set a policy that reporting workplace violence will never bring reprisals. Many organizations install confidential hotlines to enable employees to make private reports.
6. Responsibility: Designate and train the individuals who will drive the program with electronic newsletters, webinars, speakers, posters, and other kinds of educational communications designed to keep violence prevention at the top of everyone’s minds. Topics might include when to make a report, de-escalation strategies, or stories of effective prevention programs.
7. Briefing: With your policies and procedures in hand, set up an organization-wide briefing to introduce the program and the team responsible for implementing it.

Solicit and Welcome Suggestions
Every workplace violence protection program must take on the character of the organization that creates it. By soliciting and implementing suggestions considered useful, you can build a program suited to your facility and the people who make it unique.

Remember, though, this is a prevention program. It cannot stand alone without the support of your security and life safety systems, evacuation procedures, and business continuity plans.