Combating Workplace Violence in Health Care

Health care workers are five times more likely to suffer an injury on the job as compared to other workers. In high-stress settings, such as emergency departments and psychiatric units, the threat of patient-initiated violence is even greater. Yet these statistics only scratch the surface as many events likely go unreported.

Exacerbated by the pandemic, workplace violence has escalated into one of the major threats to the safety of both health care workers and patients. The issue has grown so severe that the American Hospital Association (AHA) recently announced a partnership with the FBI Behavioral Analysis Unit to assist hospitals in assessing and mitigating risks.

Whether verbal or physical, targeted violence compromises access, creates difficult work environments, and impacts the overall safety and quality of health care delivery. The connection between workplace violence and patient safety is undeniable, with evidence suggesting that the odds of violent incidents are lower in settings with strong cultures of safety.

Safety Strategies to Address Violence in Health Care Settings

Prevention efforts require a customized, multifaceted approach, and support from leadership is essential in implementing effective programs and solutions. Some components of workplace violence prevention initiatives can include:

Comprehensive Risk Assessments: Risk assessment tools allow organizations to pinpoint high-risk areas within their facilities and recognize patient-specific risks that may escalate into violent behavior. Risk assessments can be especially helpful in identifying facility conditions that could aid in prevention, such as improved lighting, discreet panic buttons, and code of conduct posters in exam rooms and common spaces.

Training and Education Programs: Equipping all health care workers, staff and providers alike, with the skills to handle challenging situations is crucial for preventing violence. Training in de-escalation techniques, conflict resolution, and personal safety measures empowers staff to respond calmly and effectively to potential threats. Many health systems, such as the Cleveland Clinic and Veterans’ Health Administration have implemented robust training programs to help staff navigate and prevent incidents of violence.

Reporting and Response Systems: A confidential and accessible reporting system is essential for tracking incidents of workplace violence and encouraging staff to report incidents without fear of retaliation. Data gathered from reports can inform leadership about trends in workplace violence and help target specific areas for intervention. Clear guidelines and reporting tools, like those of the University of California Health system, were implemented as part of a broader workplace violence prevention plan required by California law.

Public Awareness and Advocacy: One of the most critical aspects is acknowledging the harm and impact on health care workers. In their award-winning campaign, End the Silence on Health Care Violence, The University of Vermont Health Network shares moving stories from their frontline staff in hopes of generating conversation, providing community, and working towards actionable solutions.

Strategies like these are essential pieces of the puzzle, but real progress hinges on coordinated efforts across various health care organizations, government agencies, and advocacy groups. Through collaboration and prioritizing a culture of safety, institutions can better protect health care workers, improve patient care, and build a more resilient health care system for all.

Resources:

• American Society for Health Care Risk Management: Workplace Violence Toolkit

• American Hospital Association: AHA & FBI Workplace Violence Collaborative

• The New York Times: Stabbed. Kicked. Spit On. Violence in American Hospitals is Out of Control

• AXIOS: Hospitals, clinics among America's most violent workplaces

• Massachusetts Health & Hospital Association: A Call to Action: MHA Workplace Violence Report (PDF)