B ETWEEN
A
R OCK AND
P LACE
A
H ARD
T HE D ILEMMA OF W ORKPLACE
V IOLENCE IN H EALTHCARE
DILEMMA
1.
a situation in which you
have to make a difficult
choice
2.
an usually undesirable or
unpleasant choice
3.
a problem involving a
difficult choice
C OLLEGE S TATION MEDICAL
C ENTER
W HAT W E’ LL C OVER
1. What defines Workplace Violence?
2. What are our obligations in addressing
Workplace Violence?
3. Common concerns with Workplace
Violence Training
4. What methods can be utilized to train
our staff?
5. What are the benefits of addressing
Workplace Violence?
DEFINING W ORKPLACE
V IOLENCE
WORKPLACE V IOLENCE
DEFINED
FBI Report, “Workplace Violence Issues in Response”
Workplace Violence was a term that
surfaced in the Summer of 1989.
 While there is no precise measure of the
full extent and cost of violence in the
workplace, it clearly represents a major
challenge, affecting an estimated 1.7
million employees directly and millions
more indirectly every year.

(Source: U.S. Dept. of Justice)
WORKPLACE V IOLENCE
DEFINED
ASIS International:
Workplace violence refers to a broad range
of behaviors falling along a spectrum that,
due to their nature and/or severity,
significantly affect the workplace, generate
a concern for personal safety, or result in
physical injury or death.
WORKPLACE V IOLENCE
DEFINED
Four types of WPV
Type I - Criminal acts. Those events where
there is no relationship between the
business and the actor. For example, a
robbery with or without associated
homicide or assault.
WORKPLACE V IOLENCE
DEFINED
Four types of WPV
Type II - Customer/client/patient violence
Those events in which the actor is not an
employee, but has a relationship with the
business or organization as a customer,
client, or patient, and becomes violent
while receiving services, etc. For example, a
patient assaults a healthcare worker.
WORKPLACE V IOLENCE
DEFINED
Four types of WPV
Type III - Co-worker on Co-worker violence.
Those events which occur during or after
an employment relationship. An example
would include current or former co-workers
who harm or threaten to harm another
employee. This would also include
contractors and vendors.
WORKPLACE V IOLENCE
DEFINED
Four types of WPV
Type IV—Violence stemming from a
personal relationship. Those events which
occur in the workplace and stem from a
personal, or intimate, relationship with at
least one employee. These “domestic”
events can include threats, harassment or
physical harm.
WORKPLACE V IOLENCE
DEFINED
U.S. Bureau of Labor Statistics
Total of Private
Industry Assaults
Red = Healthcare
W ORKPLACE V IOLENCE
DEFINED
The National Institute for Occupational Safety &
Health
:
Acknowledges the high rate of assault in
healthcare and tells us they occur most often
during:
 Times of high
activity w/patients
 Meals
 Patient
transportation
 When setting
limits such as:
 Eating or drinking
 Tobacco use
 Alcohol use
Or during involuntary admittance
WORKPLACE V IOLENCE
DEFINED
Source:
OSHA
“Facts
About
Hospital
Worker
Safety”
Hospital Worker Injuries Resulting in Days
Away from Work, by Event or Exposure
WORKPLACE V IOLENCE
DEFINED
Causes of Fatal Workplace Injuries in
Hospitals, 2003–2011
WORKPLACE V IOLENCE
DEFINED
Causes of Injuries Resulting in Days Away from
Work for Selected Healthcare Occupations - 2011
WORKPLACE V IOLENCE
DEFINED
National Council on Compensation
Insurance
Companies paid out $126 million in workers'
compensation claims for workplace violence
in 1995.
 In 2003, NCCI updated and extended its
earlier analysis on this violence in the
workplace. The following are among the key
findings:

WORKPLACE V IOLENCE
DEFINED
National Council on Compensation
Insurance
Workers compensation claims involving a
criminal act are 10 times more likely than
nonviolence claims to involve a fatality
 Among high-risk-of-violence occupations,
incident rates remain high, particularly in
health care, the retail trade, and other
customer facing industries

EMPLOYER O BLIGATIONS IN
ADDRESSING WORKPLACE
V IOLENCE
EMPLOYER O BLIGATIONS
The
General
Duty
Clause
OSH Act of 1970
29 U.S. Code § 654
(a) Each employer—
(1) shall furnish to each of his employees
employment and a place of employment
which are free from recognized hazards that
are causing or are likely to cause death or
serious physical harm to his employees;
(2) shall comply with occupational safety
and health standards promulgated under
this chapter.
EMPLOYER O BLIGATIONS
“What gets measured gets
managed.”
- Peter Drucker
EMPLOYER O BLIGATIONS
2013 Data
44,529
total calls
---------3315 High
Risk
BROOKDALE HOSPITAL
M EDICAL C ENTER
C OMMON C ONCERNS WITH
W ORKPLACE V IOLENCE
TRAINING
C OMMON C ONCERNS
Is it really necessary?
How do we convince others of the need?
Costs
 In hiring a firm or organization
 In lost productivity to training time
 According to the Institute of Finance
and Management the average
healthcare organization spends
$5.50/employee on WPV prevention
 Fear that staff may mishandle the
training



C OMMON C ONCERNS
People (internal/external) may think
we’re admitting to a problem
 It’s too negative - we promote a
positive atmosphere
 There is too much liability incurred

TRAINING M ETHODS
U TILIZED
TRAINING M ETHODS
In-house trainers
 Select an employee (or group) to
develop a program
 Train the Trainer programs
 External organizations
 Often have expertise coupled with
knowledgeable trainers

TRAINING M ETHODS
Pitfalls…
Don’t just “check the box”
 Inadequate instruction/instructors
 Allowing the program to be watered down
or letting instructors “pick and choose”
what will be taught
 Choosing an inadequate program/vendor
 Lack of support at the administrative level

BENEFITS OF ADDRESSING
W ORKPLACE V IOLENCE
BENEFITS OF ADDRESSING
W ORKPLACE V IOLENCE
Reduced exposure to liability
 “If we would have had this program, we
wouldn’t have paid out a penny”
 Increased employee satisfaction
 “This is the first time I have ever had
training where I felt like…actually cared
about me”
 Reduced injury and time off of staff – not
dealing with:
 Lost wages
 Replacement worker
 Lower moral

BENEFITS OF ADDRESSING
W ORKPLACE V IOLENCE
Zero tolerance for inappropriate
incidents
 With the right program, staff members
can be trained in:
 Recognizing and Diffusing Conflict and
Aggression
 Safety awareness
 Legal issues
 Restraining violent individuals

R ENOWN R EGIONAL M EDICAL C ENTER C ENTER FOR A DVANCED M EDICINE
QUESTIONS?
Mike Owen | Program Manager
Watch House International
(o) 888.225.9569 | (m) 417.818.2319
www.WatchHouseInt.com | www.TheSafeApproach.com