Elevating Workplace Safety to Combat Healthcare Violence Against Workers

The healthcare workforce is in crisis. From devastating staffing shortages to unmanageable levels of stress and burnout, today’s healthcare workers are desperate for some relief. Unfortunately, exacerbating these already significant challenges is an increasing rate of workplace violence in healthcare. 

According to the results of a study published recently in the American Journal of Preventive Medicine, about one-third of public healthcare workers have experienced at least one incident of workplace violence during the COVID-19 pandemic. And that’s just one of many reports that demonstrate the severity of the issue. 

There are some very important things that can be done to better protect healthcare workers, but at the top of that list should be elevating workplace safety to a key performance indicator (KPI) for healthcare systems. Unless there is a top-down focus on this issue, healthcare workers will continue to be putting themselves in danger simply by going to work and attempting to provide care to the people most who, according to a study in the Annals of Medicine and Surgery,  are most likely to engage in violence against them.

Nobody outside healthcare knows how bad it’s gotten

Although workplace violence in healthcare is an issue for all types of healthcare workers, it is most often nurses who bear the brunt of workplace violence. Last year, a Press Ganey analysis surprised many, stating that an average of 57 nurses are assaulted every day — that’s about 2 every hour. While terrifying incidents of shootings may make the news, every day, all across the United States (and the world), nurses are punched, spit on, kicked, and otherwise harassed. 

Too often, this is considered just “part of the job.” When examining nonfatal workplace injuries and illnesses across all sectors, healthcare workers account for about three-quarters of all incidents, according to the Bureau of Labor Statistics. Such incidents have certainly increased since the onset of the COVID-19 pandemic, but violence against healthcare workers was already trending upwards, with the rate of injuries related to workplace violence perpetrated against medical professionals growing by 63% between 2011 and 2018.

 The importance of leadership involvement in preventing hospital incivility and violence 

Leaders play a pivotal role in preventing hospital incivility and violence by sending a clear message that certain behaviors are not acceptable and will not be tolerated in the workplace. In nearly every other industry, individuals who display threatening or inappropriate behavior are removed from the workplace. However, in the healthcare industry, healthcare workers cannot simply send badly behaving patients home. Instead, leaders must develop systems and protocols to ensure the safety of everyone.

Leaders can implement policies and procedures that promote a safe and respectful workplace. For example, they can provide training for staff members on how to recognize and de-escalate potentially violent situations. This training can include techniques for communicating with agitated or aggressive patients, as well as strategies for diffusing tense situations before they escalate into violence. Leaders can also develop escalation plans that outline clear steps for dealing with violent or disruptive behavior, such as calling security or involving law enforcement.

Additionally, leaders can establish reporting systems for incidents of violence or incivility. These systems encourage staff members to report incidents without fear of retaliation and provide a clear and consistent process for addressing reports of violence or incivility. Leaders can ensure all staff members are aware of these reporting systems and that they understand the importance of reporting incidents in a timely and accurate manner.

By prioritizing workplace safety and taking an active role in preventing incivility and violence, leaders not only create a safer workplace for staff and patients but also foster a more positive work environment where employees feel valued and supported. This, in turn, can lead to increased job satisfaction, reduced turnover rates, and improved patient outcomes. 

How Digital Technology can Help

Mitigating workplace violence is not a one-and-done initiative. It is something that healthcare organizations must consciously address every day, and no single intervention or policy will solve the issue. However, digital engagement technology has the potential to improve communication between patients and the care team (and among the care team) and increase transparency around activities related to a patient’s care, giving them more insight into what is happening around them, which can help to prevent violent incidents. 

Digital health technology, via either TVs or mobile devices, can be used to provide clear prompts to patients and their families, clearly communicating that any physical or verbal violence or abuse will not be tolerated. This same technology can be used throughout the facility or specifically on high-risk units to communicate when a patient is displaying violent behavior. 

Digital signage can also be used to indicate a room where there is a potentially aggressive or violent patient, and facility-wide alerts can be sent to communicate to entire floors or units when there is an issue. These tools can be customized to hospital codes so that all staff members quickly and easily know what they should do in the event of a violent incident.    

The healthcare industry needs outside support to prevent workplace violence 

Despite advancements in digital technology and tools for healthcare workers, the issue of workplace violence remains a pressing concern for healthcare professionals. Nearly a year ago, thousands of nurses marched in Washington, D.C., asking for changes to nurse-to-patient ratios, the staffing shortage, and workplace violence. And before that, Democratic Representative Joe Courtney introduced H.R. 1195, the Workplace Violence Prevention for Health Care and Social Service Workers Act, aimed at putting processes around workplace safety. Under the act, any company, facility, or organization to employs healthcare or social service workers would be required to:

• Conduct a risk assessment 
• Develop and implement a prevention plan
• Ensure all employees receive workplace violence prevention training 
• Investigate all occurrences of workplace violence 

But the bill, which has been passed by the House of Representatives, has stalled in the Senate–

despite support from the American Nurses Association and National Nurses United, the nation’s largest nurses union. 

The bottom line is that we must  do better by nurses and other healthcare workers. We have the digital technology and tools to arm them with better ways to communicate with patients and with each other. But we need understanding and support from executive leaders. Leaders have an opportunity that is powered to a meaningful degree by technology yet centered on human connection and one that explicitly rejects the notion that violence and safety threats are “part of the job.” It is incumbent upon healthcare executives to elevate the safety of the care environment to the top of their organization’s system-wide strategic plan and make it a key performance indicator for leaders at all levels. 

About Katherine Virkstis
Katherine Virkstis is Vice President of Clinical Advisory Services, at Get Well where she leads the company’s nursing and clinical vision. Katherine has worked with hundreds of executive teams at healthcare organizations in more than 50 countries and is trained as a primary care physician.

References:

1. https://www.ajpmonline.org/article/S0749-3797(22)00507-4/fulltext
2.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9206999/
3. https://www.bls.gov/iif/home.htm
4. https://www.pressganey.com/platform/ndnqi/
5. https://www.congress.gov/bill/117th-congress/house-bill/1195/text

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