BETWEEN A ROCK AND A HARD PLACE

THE DILEMMA OF WORKPLACE VIOLENCE IN HEALTHCARE

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

COLLEGE STATION MEDICAL CENTER

WHAT WE’LL COVER

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 WORKPLACE VIOLENCE

WORKPLACE VIOLENCE 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 VIOLENCE 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 VIOLENCE 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 VIOLENCE 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 VIOLENCE 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 VIOLENCE 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 VIOLENCE DEFINED

U.S. Bureau of Labor Statistics

Total of Private Industry Assaults

Red = Healthcare

Total of Private Industry Assaults

Red = Healthcare

WORKPLACE VIOLENCE 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 VIOLENCE DEFINED

Hospital Worker Injuries Resulting in Days Away from Work, by Event or Exposure

Source:OSHA “Facts About Hospital Worker Safety”

WORKPLACE VIOLENCE DEFINED

Causes of Fatal Workplace Injuries in Hospitals, 2003–2011

WORKPLACE VIOLENCE DEFINED

Causes of Injuries Resulting in Days Away from Work for Selected Healthcare Occupations - 2011

WORKPLACE VIOLENCE 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 VIOLENCE DEFINED

National Council on Compensation Insurance

Workers compensation claims involving a criminal act are 10 times more likely than nonviolence claims to involve a fatalityAmong high-risk-of-violence occupations, incident rates remain high, particularly in health care, the retail trade, and other customer facing industries

EMPLOYER OBLIGATIONS IN

ADDRESSING WORKPLACE VIOLENCE

EMPLOYER OBLIGATIONS

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.

The General

Duty Clause

EMPLOYER OBLIGATIONS

“What gets measured gets managed.”

- Peter Drucker

EMPLOYER OBLIGATIONS

2013 Data

44,529 total calls----------

3315 High Risk

BROOKDALE HOSPITAL MEDICAL CENTER

COMMON CONCERNS WITH WORKPLACE

VIOLENCE TRAINING

COMMON CONCERNS

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

COMMON CONCERNS

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 METHODS UTILIZED

TRAINING METHODS

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 METHODS

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

WORKPLACE VIOLENCE

BENEFITS OF ADDRESSING WORKPLACE

VIOLENCE 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 WORKPLACE

VIOLENCE 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

RENOWN REGIONAL MEDICAL CENTER -

CENTER FOR ADVANCED MEDICINE

QUESTIONS?

Mike Owen | Program ManagerWatch House International

(o) 888.225.9569 | (m) 417.818.2319www.WatchHouseInt.com | www.TheSafeApproach.com