Creating a Culture of Safety
Creating a Culture of Safety
Presented by the UMHHC Security Services
www.med.umich.edu/i/security/
In an emergency, Dial 911
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UMHHC Security provides emergency (911) response 24 hours a day 7 days a week on
the main medical campus, 300 NIB, Kellogg Eye Center and EAA Campus
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Campus Public Safety/Police provide emergency (911) service to the Medical School,
400 NIB and the rest of the Ann Arbor UM campuses
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Emergencies include:
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Fire
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Cardiac arrest
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Crimes in progress
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Medical emergencies
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Assault
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Dangerous behavior
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Escalating, out-of-control behavior
UMHHC: A Small City
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As in any small city, emergencies like fires, crimes, sudden accidents and illnesses, and
dangerous behavior occur here.
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Our population, however, is quite different than that of a typical small city. Many of our
patients and visitors experience a high degree of uncertainty and apprehension, related
to their medical condition, and function under prolonged tension and strain; stresses
like these may result in sudden anger or loss of control providing human services
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“Nonviolent Crisis Intervention”
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Crisis development behavior levels
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Personal Space
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Body Language
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Para verbal Communication
Updated January, 2013
©2004 UM-HRD, UMHS
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Creating a Culture of Safety
Recognizing early warning signs of violent behavior
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Direct or veiled verbal threats of harm
Intimidation of others. This can be physical or verbal intimidation. Harassing phone
calls and stalking are examples.
Restraining order being filed and served to an employee’s, patient’s, physician’s family
member.
Carrying a concealed weapon or flashing a weapon to test reactions.
Paranoid behavior. Perceiving that the whole world is against them.
Moral righteousness and believing the organization is not following its rules and
procedures.
Unable to take criticism of job performance. Holds grudge, especially against a
supervisor. Often verbalizes hope for something to happen to the person against whom
the employee has the grudge.
Expression of extreme desperation over recent family, financial, or personal problems.
History of violent behavior.
Extreme interest in semi-automatic or automatic weapons and their destructive power
to people.
Fascination with incidents of workplace violence and approval of the use of violence
under similar circumstances.
Disregard for the safety of co-employees
Obsessive involvement with the job, often with uneven job performance and no
apparent outside interests.
Being a loner who has a romantic obsession with a co-worker who does not share this
interest.
©2004 UM-HRD, UMHS
Creating a Culture of Safety
Tools for Managing Aggressive and/or disruptive behavior
http://www.med.umich.edu/i/security/behavior.htm
This web page was developed to give UMHS staff easy access to the training, tools and
resources that are available for managing aggressive and/or disruptive behavior before it gets
worse.
Physical Violence
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Make a rapid assessment
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Call 911
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Implement your department’s Critical Incident Plan
- Have discussion within your department about proper responses to specific threats.
Verbal De-escalation
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Managing verbally aggressive behavior is an essential skill for supervisors, and all staff
providing human services
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“Nonviolent Crisis Intervention”
- Crisis development behavior levels
- Personal Space
- Body Language
- Para verbal Communication
Threats
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Security must get involved
Threat Interventions
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Background investigation - Our PVP Program
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Verbal intervention
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Combined mental health and law enforcement intervention
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Family assistance
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Treatment remedies
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Civil remedies
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Unit security
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Close security
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Personal protection
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Force remedies
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Criminal remedies
Updated January, 2013
©2004 UM-HRD, UMHS
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Creating a Culture of Safety
Risk Codes
- (S0) - No Security Response: Investigation only.
- (S1) - First Level Response: Observe & Verbal Interactions (if needed).
- (S2) - Second Level Response: Observe, verbal & active physical management (if needed).
- (S3) - Third Level Response: Observe & preventative force (including law enforcement as
needed)
- (S4) - Fourth Level Response: Observe & preventative force. Security presence during visit.
- (S5) - This is indicating that the PVP maybe a family member that is not a patient or in our
system.
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©2004 UM-HRD, UMHS
Creating a Culture of Safety
Case #1
A clerical staff member in Mott has left her husband, taking their five-year-old child with her.
They’re living temporarily with a relative. Her husband calls her at work and says, “I know
where you park,” and hangs up. The staff member is afraid to tell her supervisor fearing
repercussions. Other staff on the unit know something’s wrong, and rumors are circulating. She
confides in a colleague, who urges her to report the threat which she does.
The staff member says that she and her child had been physically abused by the husband. The
husband’s criminal history indicates that he has a two-year-old conviction for child abuse, for
beating their child with an electric cord, and is on probation.
Case #2
A female neurologist examines a 45-year old closed head injury victim. After the exam, the
patient tells the physician that she’d better qualify him for SSI income, or he’ll kill her. The
physician reports the threat to Security.
An investigation reveals that the patient has been convicted of five felonies during his lifetime.
Four of the convictions were for assaultive offenses, and the fifth for a property crime. The
victims in three of the assaults were female.
Updated January, 2013
©2004 UM-HRD, UMHS
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Creating a Culture of Safety
Case #3
A former patient enters a clinic demanding to be seen. He escalates and begins shouting,
berating the clerk. The patient believes that he was permanently harmed as the result of a
procedure done in this clinic four years before, although this is not true. About once a year
since then, he storms into the clinic demanding to be seen. The clinic supervisor intervenes and
attempts to schedule an appointment. While talking with her, he shows her a permit to carry a
concealed weapon, points to his coat pocket and demands to be seen immediately.
Case #4 Potentially Violent Employee
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©2004 UM-HRD, UMHS
Creating a Culture of Safety
Resources
Guidelines for handling violence in the workplace
www.med.umich.edu/i/policies/umh/Violence.html
Disruptive employee policy
www.med.umich.edu/i/policies/umh/04-06-047.htm
Disruptive visitor and patient policy
http://www.med.umich.edu/i/policies/umh/62-10-004.html
UMHS Critical Incident Video
https://mlearning.med.umich.edu/quiz/cbtlib/modules/criticalcombined/index.htm
The Crisis Prevention Institutes, Non-Violent Crisis Intervention Training is available for staff.
If interested please call (734) 936-6832.
On the Internal Homepage (http://www.med.umich.edu/i/) Click on Threatening/Aggressive
Behavior (found under Home Pages/Other Resources). This takes you to the Security and
Entrance Services page: www.med.umich.edu/i/security/behavior.htm
You can also access this information from the Clinical Homepage
(www.med.umich.edu/clinical/) Click on Help with Aggressive Behavior. This will take you to
the Security and Entrance Services page.
Updated January, 2013
©2004 UM-HRD, UMHS
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