- About PS&F
- Industry Focus
- Client Tools
- Education & Events
September 13, 2018
Imagine for a moment that it is 10 a.m. on a typical Tuesday morning. The healthcare clinic is bustling, everyone is preoccupied with their day, and the unthinkable happens: someone pulls out a gun in the lobby and starts shooting. As a risk manager, what would you do? How well-prepared is your team?
Workplace violence occurs in the healthcare industry at a rate of four times that of any other industry according to the Bureau of Labor Statistics, with 7.8 cases of serious workplace violence injuries per 10,000 full-time employees (FTEs) compared to construction, manufacturing, and retail, which all had fewer than two cases per 10,000 FTEs. According to OSHA, workplace violence is any “act or threat of physical violence, intimidation, harassment or other threatening disruptive behavior that occurs at the workplace.” The factors that increase workplace violence in healthcare can include the close proximity between patient and provider (including working alone); providers working with people who have a history of violence or may be under the influence of drugs; the lifting, movement, and transport requirements of patients; and more. Workplace violence is vastly underreported, with studies showing that only about 70 percent of assaults are being reported. Senior living (nursing/residential care facilities) has the highest rate of assaults within healthcare, accounting for 19 percent of all violent acts in the industry. How is your healthcare organization addressing this significant issue?
From 2011 to 2013, US healthcare workers suffered 15,000 to 20,000 workplace violence related injuries every year that required significant time away from work for treatment and recovery. In hospitals, surgery centers, nursing homes, and other healthcare settings, possible sources of violence include patients, visitors, coworkers, intruders, and business vendors. Verbal threats, physical attacks of abuse, gang violence, and active shooters are all now common examples of workplace violence that is permeating the healthcare industry. Active shooters have become prevalent the past several years within healthcare and, with the security of patients and providers at the forefront of every healthcare organization’s mind, each entity should have an active shooter risk mitigation policy put into place. All of this violence comes at a significant cost. It harms workers both physically and emotionally, and makes their job more difficult. Employers suffer from significant workers’ compensation losses, in addition to the added costs of overtime, recruitment, temporary staffing, et cetera.
In the majority of healthcare workplaces where risk factors can be identified, the risk of an assault can be minimized or prevented if employers take the appropriate actions.
Active shooter insurance policies, which pay for death and serious injuries like blindness and total disability, came to fruition in 2014. With the increased occurrence of active shooter incidents, such as last year’s shooting at a Florida high school in which 17 people were killed, the demand for active shooter policies has grown dramatically. This sort of coverage should be considered by higher risk urban healthcare organizations that are located in areas of higher crime or homicide rates. While healthcare has not seen the same numbers and scale of mass shooting incidents that have occurred in schools, churches, and night clubs, several large healthcare systems have considered and purchased this insurance to mitigate the risks and costs associated with such an incident.
In the majority of healthcare workplaces where risk factors can be identified, the risk of an assault can be minimized or prevented if employers take the appropriate actions. OSHA has developed a roadmap for healthcare providers to shore up the risks associated with workplace violence in a publication called Guidelines for Prevention of Violence in Healthcare. The best way to reduce violence in the workplace is through a solid workplace violence prevention program that includes these five core elements.
These five core elements are all interrelated and each one is necessary to the success of the overall program. Setting up an internal committee that oversees the plan can help ensure program success. The internal committee should include management, HR, and people on the “front lines,” such as your physicians or nurses. To meet the objectives of the plan, the committee should hold regular meetings, strongly encourage worker involvement in the decisions that affect their health and safety, and address employees’ safety concerns in a timely manner. Establish quarterly meetings and solicit input from employees with an annual communication campaign. If you have conducted an annual employee feedback survey, be sure to incorporate those results as well. Having this communication from the CEO/management about the importance of this subject matter will drive employee involvement. Engaging employees should in turn lead to enhanced employee perceptions of safety and more proactive workplace violence mitigation.
Numerous case studies and examples are available that provide real world examples of healthcare organizations implementing workplace violence prevention programs and the benefits of implementing such programs. Take this great example:
This health system’s example has been effective because they make a clear effort to prioritize reporting workplace violence. They keep their prevention plan simple and utilize their company-wide reporting system to respond proactively to individuals before a potential event occurs. This type of preemptive risk management is something that other healthcare entities can emulate by allocating appropriate resources and effort to this serious issue.
These sorts of workplace violence monitoring and reporting programs start with management and empower all levels of employees to speak up and report. Organizations that do not have a workplace violence plan in place could be held liable should an individual, who should have had disciplinary action (termination, paid leave, etc.) for prior behavior or incidents, cause an event.
How are you addressing these exposures within your organization? Partnering with a well versed risk mitigation partner, such as an insurance broker, will help your organization in identifying how your operations can reduce workplace violence.
Resources and References
The views and opinions expressed within are those of the author(s) and do not necessarily reflect the official policy or position of Parker, Smith & Feek. While every effort has been taken in compiling this information to ensure that its contents are totally accurate, neither the publisher nor the author can accept liability for any inaccuracies or changed circumstances of any information herein or for the consequences of any reliance placed upon it.