Workplace violence includes not only events involving active shooters or physical violence that make the news; it also is the everyday occurrences, such as verbal abuse, that are often overlooked. In health care, violence is especially prevalent—healthcare workers are four times more likely to be victimized than workers in private industry, according to an article on The Joint Commission website.

Contributing factors associated with perpetrators of violence in health care include an altered mental status or mental illness, patients in police custody, long wait times or crowding, being given “bad news” about a diagnosis, gang activity, domestic disputes among patients or visitors, and the presence of firearms or other weapons. To help address these contributing factors, the alert provides seven actions suggested by The JointCommission:

• Clearly define workplace violence and put systems in place across the organization that enable staff to report workplace violence instances, including verbal abuse

• Recognizing that data come from several sources, capture, track and trend all reports of workplace violence — including verbal abuse and attempted assaults when no harm occurred, but in which the health care worker feels unsafe

• Provide appropriate follow-up and support to victims, witnesses and others affected by workplace violence, including psychological counseling and trauma-informed care if necessary

• Review each case of workplace violence to determine contributing factors. Analyze data related to workplace violence, and worksite conditions, to determine priority situations for interventions

• Develop quality improvement initiatives to reduce incidents of workplace violence

T• rain all staff, including security, in de-escalation, self-defense and response to emergency codes

• Evaluate workplace violence reduction initiatives

“Leadership needs to make the safety of health care workers a top priority and encourage candor in reporting. Health care workers are often hesitant to report violence because they think that it is part of the job or believe that patients are not responsible for their actions,” said Ana Pujols McKee, MD, executive vice president and chief medical officer, The JointCommission.

“When violence occurs, it should be immediately reported to leadership, internal security and, as needed, to law enforcement. Such reporting can help health care organizations analyze what happened and inform actions that need to be taken to minimize risk in the future.”

The alert provides The Joint Commission’s related standards, references and resources—including those from the Occupational Safety and Health Administration, Crisis Prevention Institute, Centers for Disease Control and Prevention, and Centers for Medicare & Medicaid Services. An accompanying downloadable infographic also is available for health care organizations to print and share at their facilities.