What California can teach us about preventing workplace violence in healthcare

July 21, 2016 Stephanie Radcliffe


According to the World Health Organization: 

Health workers are at high risk of violence all over the world. Between 8% and 38% of health workers suffer physical violence at some point in their careers. Many more are threatened or exposed to verbal aggression. Most violence is perpetrated by patients and visitors. 

A review published in April in the New England Journal of Medicine (NEJM) stated even higher numbers, with 46% of nurses reporting workplace violence during their five most recent shifts and one-third said they were physically assaulted in one study. The NEJM article declared that "Health care workplace violence is an underreported, ubiquitous, and persistent problem that has been tolerated and largely ignored."

While injuries to patients have received much-needed media attention and quality improvement efforts, the same attention hasn't carried over to employee harm. Luckily, states like California have begun to take notice. The state is set to pass Workplace Violence Prevention in Health Care (WPV) safety standards this summer. Although capturing and reporting on WPV data has not been ‘mandated’ yet, many facilities have started capturing data in anticipation of the new rules taking effect (probably in 2017). 

California's new regulations aim to protect healthcare workers against violence and will apply to many healthcare facilities, including all acute care hospitals, outpatient clinics and home healthcare. Some things the proposed standards will mandate facilities establish are:
  • A workplace violence prevention program, involving employees in the process
  • Communication between transport and receiving institutions when transferring potentially violent patients
  • Systems to log, respond to and investigate violent incidents and situations
  • Evaluate what they can change to curtail violent incidents committed against employees and patients
  • Assess where acts of violence are most likely to occur, such as infrequently used staircases, and mitigate the likelihood of their occurrence 
  • Work practices that are more protective of employees
  • Training to improve recognizing the signs of violent behavior and how to handle incidents
Regulations like these will involve much planning and coordination between your facility's departments including risk management, occupational health/employee safety, security, and human resources (for staff training). 

At RL, we've been working closely with our California clients to ensure they're capturing the right information in RL6 and are ready to start reporting when the regulation is finalized. That includes customizing forms to allow healthcare organizations to capture details about violent incidents, so they can investigate them quickly.

Are you an RL client? Connect with other California clients on the HUB to learn what others are doing

While reporting won't fix the problem, it's an important first step. When hospitals were mandated to report never events, numbers plummeted. Hopefully, we'll soon have the same results with employee harm events. A report from the Government Accountability Office found that 4 out of 5 studies on violence prevention programs suggest that violence prevention programs can reduce the rate or severity of assaults. Eventually, hospitals can even aim for zero-tolerance workplace violence policies like other industries.

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