By Dan Hounsell, Senior Editor

Workplace violence in hospitals and other healthcare facilities already was a problem before 2020. Front-line employees, as well as administrative and support staff in facilities, were increasingly targets of violence from patients and visitors. 

Then the COVID-19 pandemic broke out in March 2020, and the workplace violence problem became exponentially worse. Healthcare facilities managers found themselves confronted with an even greater challenge to provide safety and security within their buildings. The crisis even prompted the Joint Commission to revise its workplace violence standards. 

For managers looking to implement or update a workplace violence prevention program in their facilities, Lisa Terry, vice president of vertical markets-healthcare with Allied Universal Security Services, offered a five-step action plan during her presentation at the ASHE Annual Conference in Boston in July.  

1. Engagement 

Because the security function incorporates a range of interested parties inside and outside healthcare organizations, Terry says the first step in the process is engaging staff, leadership and external partners in the  process by: 

• building cross-functional teams to break down silos and get important work accomplished 
• emphasizing that a safe and secure environment produces a productive workforce and a gratified patient population 
• building partnerships among security, patient safety, nursing, compliance, risk management and human resources, as well as external regulatory agencies. 

2. Resources 

Terry next highlighted useful resources healthcare facilities managers can tap into for critical insights on developing a workplace violence prevention program: 

• The Joint Commission 2022 workplace violence prevention standards 
• Creating Safer Workplaces, a publication from the International Association for Healthcare Security & Safety/American Hospital Association (IAHSS/AHA) 
• Lessons learned from California’s OSHA workplace violence rule 

To support these resources, Terry encourages managers to empower staff to report incidents of workplace violence; implement a system to investigate and document incidents; and consider prosecution of offenders as appropriate. 

3. Threat mitigation 

What is a threat of violence in the workplace for healthcare facilities? Terry points to this definition from the IAHSS Guidelines Council: any verbal or physical conduct or situation that conveys, or could be implied or perceived to convey, an intent to directly or indirectly threaten safety, negatively impact physical or psychological well-being or damage an organization’s property. 

Referring to IAHSS Management of Threats Guideline 01.09.03, she says managers need to support the mitigation process by establishing a process and multi-disciplinary team to identify, assess, validate, mitigate and respond to threats of violence or other behaviors of concern. 

4. Training 

Because workers in healthcare facilities, including facilities staff, are most vulnerable to workplace violence, they must play a critical role in identifying, preventing and responding to it. Terry says staff training on workplace violence starts with establishing a definition and implementing a process for reporting workplace violence. Training also must cover: 

• non-escalation and de-escalation 
• proper use of personal protection equipment 
• onboarding and regular refreshers. 

5. Review 

The final critical component of workplace violence prevention programs in healthcare facilities is an on-going review process that is designed to ensure quality improvement, Terry says, emphasizing the role of auditing the program regularly. 

“Make sure you have somebody who audits the program, whether they’re in-house or someone from outside,” she says. Among the key components of the audit are: 

• a dedicated team’s ongoing efforts to mitigate risk 
• data collection and analysis that includes: reports of workplace violence; workers compensation injuries; recruitment and retention efforts in areas with high levels of workplace violence 
• soliciting input and buy-in from multiple internal and external partners. 

Dan Hounsell is senior editor of the facilities market. He has more than 25 years of experience writing about facilities maintenance, engineering and management.