Let’s Stop Violence against Healthcare Professionals

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The first statistic quoted at the 2016 Healthcare Security Summit sounded like a mistake: “There were more assaults against healthcare and social service workers than in any other industry.” While we couldn’t validate the claim with our own research, the available OSHA data are frightening:
 
From 2002 to 2013, incidents of serious workplace violence (those requiring days off for the injured worker to recuperate) were four times more common in healthcare than in private industry on average. In 2013, the broad “healthcare and social assistance” sector had 7.8 cases of serious workplace violence per 10,000 full-time employees (see graph below). Other large sectors such as construction, manufacturing, and retail all had fewer than two cases per 10,000 full-time employees.

That statistic set the stage for the day and got the attention of both the healthcare professionals in the room and the many law enforcement officers and healthcare security personnel. Near Southwest Preparedness Alliance (NSPA1.org) hosted it’s 2016 Healthcare Security Summit in Roanoke, Virginia on June 16.
 
Rick Arrington, retired Roanoke cop and now crime prevention consultant with Virginia’s Department of Criminal Justice Services, led a discussion about risk analysis and risk management for hospitals and long-term care facilities. Some of the causes of healthcare violence include:
  • Too-early release of injured and unstable patients due to insurance guidelines
  • Available narcotics in hospital settings attract addicts
  • Fights between patients and between patients’ families (if the victims of a street fight are transported to the E.D., and both sides of the fight end up in the same hospital, the fight might continue there)Frustration at hospital and insurance policies
  • Understaffing
The risk to healthcare facilities includes physical location, layout, and “open design;” political reaction to controversial services provided by the institution; and prior events. Rick then discussed options for risk avoidance, risk acceptance, risk transfer, and risk reduction. Establishing (and enforcing) patient and visitor responsibilities is one step towards spreading risk.
 
Rick Arrington seems to be a big believer in physical barriers – walls, glass, elevation, separate parking areas for staff – and a lesser believer in the effectiveness of electronic devices like access control, surveillance video, and alarms.
 
CPR’s view of workplace violence in healthcare:
  1. It must be dramatically reduced. Those who care for others deserve a safe workplace.
  2. After-action reports are critical learning tools. Who is causing harm, where in the facility, and when? Precise knowledge helps define safety improvements.
  3. Train all employees to diffuse violent situations, report threats, and defend themselves, their colleagues and their patients.
  4. Regularly exercise plans, policies, and procedures aimed at reducing assaults, and improve them after each exercise.
 
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